经皮纳米刀消融小型猪肝组织的安全性及有效性  

Safety and effectiveness of hepatic ablation in swine by percutaneous NanoKnife

作　　者：张欣[1] 肖越勇[1] 杜鹏[2] 张肖[1] 何晓锋[1] 邢宁[1] 李捷[1] 杨杰[1] 王雪丹[1] 

机构地区：[1]中国人民解放军总医院放射科,北京100853 [2]中国人民解放军海军总医院放射科,北京100048

出　　处：《中国介入影像与治疗学》2015年第5期259-262,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家科技支撑课题(2013BAI17B00)

摘　　要：目的从消融机制、影像学及组织学方面评价经皮纳米刀消融小型猪肝组织的安全性及有效性。方法经动物实验伦理委员会批准,对10只巴马小型猪行CT引导下肝脏纳米刀消融术。两个电极探头距离1.5cm,每个消融过程使用90个1500V/cm以上的脉冲,共产生24个消融区。于消融术后即刻、3天、1周、2周及4周对消融区域进行影像学(CT/MRI)及组织学评价。组织学评价包括HE染色、Von Kossa染色、vWF染色和TUNEL测定。结果所有实验动物均存活至指定时间,无严重并发症发生。CT、MRI可很好地显示消融区域;HE染色、Von Kossa染色和vWF染色显示消融区细胞非热效应死亡,与正常肝组织分界明显,胆管与血管形态完整;TUNEL检测消融区内死亡细胞呈阳性反应,即纳米刀消融引发细胞凋亡。结论采用纳米刀消融小型猪肝组织安全、有效,消融区内细胞完全凋亡,血管、胆管等重要结构未见损伤。Objective To evaluate the safety and effectiveness of hepatic ablation in swine by percutaneous NanoKnife in- volving mechanism, radiologic and pathologic characteristics of the lesions. Methods On approval of the animal research committee, 10 BAMA miniature pigs underwent CT-guided NanoKnife of normal liver. Two electrode probes were posi- tioned 1.5 cm apart. The ablation procedure was performed using 90 pulses of 1500 V/cm. A total of 24 ablation zones were created. Radiologic （CT/MRI） and histopathologic analysis were performed on the day of ablation, 3 days, 1 week, 2 weeks and 4 weeks after ablation. Pathologic analysis included hematoxylineosin （H-E）, Von Kossa staining, yon Willi- brand factor （vWF） staining, and terminal deoxynucleoitidyl transferase dUTP nick end labeling （TUNEL） assay. Results All animals were survived until lethal injection. No major complications were encountered. The ablation zones were well characterized with CT and MR imaging. HE, Von Kossa and vWF staining showed cell death with a sharply demarcated ablation area, and without evidence of heat sink. Bile ducts and vessels were completely preserved. Positive effect of cell death for apoptotic markers （TUNEL） occurred in ablated areas, suggesting involvement of the apoptotic process in the pa- thology of cell death caused by NanoKnife. Conclusion NanoKnife appears to be safe and effective for hepatic ablation in an animal model, causing cell death by means of apoptosis. The vital structures proves preservation, including blood ves- sels and bile ducts.

关 键 词：消融 纳米刀 不可逆电穿孔 细胞凋亡 动物实验 

分 类 号：R730.5[医药卫生—肿瘤]