集束电极射频消融肺癌的热场分布和临床病理研究.pdfVIP

《癌症进展》杂志编辑部 集束电极射频消融肺癌的热场分布和临床病理研究 赵 健 1# 王远东 1 吴一龙 2 1 广州医学院临床肿瘤中心暨广州市肿瘤医院胸外科，广州510095 2 广东省人民医院肿瘤中心 广州510080 摘 要 目的 观察术中集束电极射频消融肺癌的热场分布、病理改变。探讨集束电极 射频消融肺癌的有效范围和对周围肺组织的影响。方法 对 12 例术中探查不能切除的非小 细胞肺癌进行集束电极射频消融治疗，同时观察肿瘤组织、周围肺组织的温度变化;随后观 察肿瘤组织凝固坏死的形态、范围和肿瘤细胞的病理变化。 结果 术中肺癌射频消融的最 高温度比体外肝组织射频消融温度高，中心区最高达 118±2 ℃，温度在肿瘤周围肺组织中 陡降。射频消融凝固的范围大于在体猪肝消融的范围，横经平均为4.0cm，纵经为2.8cm， 光镜下肿瘤细胞凝固性坏死; 电镜下肿瘤细胞细胞膜破坏，细胞器崩解，细胞核固缩。 结论 术中不可切除肺癌集束电极射频消融能毁损肿瘤组织，产生较大的凝固性坏死灶。温度在肿 瘤组织中呈缓慢递减分布，而在周围肺组织中迅速下降。肺癌射频消融存在 “温室效应”。 关键词 射频消融 集束电极 非小细胞肺癌 肺转移瘤 中图分类号 R734.1 文献标识码 A An approach to the thermal distribution and pathological change to the efficacy of the radiofrequency ablation on lung cancer Zhao Jian 1 # Wang Yuandong 1 Wu YiLong 2 1Dept Chest Surgery ，Guangzuo Tumor Hospital，Guang zuo5100952Guangdong People Hospital Tumor Center ，Guangzuo510080 Objective To observe the thermal distribution and pathological change of lung cancer in intraoperative ra-diofrequency，and to investigate the efficacy of the radiofrequency ablation on lung cancers and its influence on the nearby tissues of the lung ，so as to provide a basis for the radiofrequency ablation of the lung cancers.Methods 12patients with unresectable non-small cell lung cancer accepted the intraoperative radiofrequency ablation.The temperature change in the tissue around the electrode and surrounding tissue were monitored dur-ing the ablation，and the coagulation size，shape and histopathology were observed after it.Results During intraoperative radiofrequency ablation of unresectable lung cnacer ，the highest temperature in center region around the primary electrode was118℃±2 ℃.The temperature of lung tissue surrounding tumor decreased △本文课题受广东省医学科研基金资助 （编号:2001592） # 通讯作者 （Corresponding author ），phone:0203225 rapidly.T