射频消融联合骨水泥对兔VX2椎旁肿瘤的杀伤作用  

The killing effect of radiofrequency ablation combined with polymethylmethacrylate injection on paravertebral VX2 carcinoma in experimental rabbits

作　　者：冯国栋[1] 何仕诚[2] 杜瑞杰[1] 虞文辉 朱海东[2] 方文[2] 郭金和[2] 邓钢[2] 

机构地区：[1]东南大学附属中大医院放射科,南京210009 [2]东南大学附属中大医院介入与血管外科,南京210009

出　　处：《介入放射学杂志》2016年第6期519-523,共5页Journal of Interventional Radiology

基　　金：国家自然科学基金(81171434);江苏省临床医学科技专项项目(BL2013029)

摘　　要：目的探讨射频消融(RFA)联合聚甲基丙烯酸甲酯骨水泥对兔VX2腰椎旁肿瘤的杀伤作用。方法 CT导引下经皮穿刺成功构建兔VX2腰椎旁移植瘤模型48只,随机分为4组,每组12只。A组兔模型瘤灶中心先行RFA,后注入骨水泥0.5 ml;B组单纯注入骨水泥0.5 ml;C组单纯RFA;D组注入生理盐水0.5 ml,作为对照组。术后24 h处死全部4组模型兔,分别在瘤灶中心或距骨水泥边缘5、10、15、20 mm处不同方向各取2 mm大小组织块4块,检测肿瘤细胞凋亡指数。结果 A、B、C组手术成功率均为91.7%(11/12),D组为100%(12/12)。A、C组瘤灶中心半径10 mm范围内肿瘤细胞呈大片状凝固性坏死,细胞形态消失,几乎检测不出凋亡存在。A组距骨水泥边缘10、15、20 mm处平均肿瘤细胞凋亡率分别为(69.48±1.27)%、(59.05±3.02)%、(21.03±2.20)%,与对照组(10.25±0.79)%相比差异均有统计学意义(P<0.01);B组距骨水泥边缘5、10、15 mm处平均肿瘤细胞凋亡率分别为(62.52±2.07)%、(45.07±3.14)%、(17.41±1.12)%,与对照组相比差异均有统计学意义(P<0.01),而20 mm处平均肿瘤细胞凋亡率为(11.15±0.97)%,与对照组相比差异无统计学意义(P>0.01);C组距瘤灶中心10、15、20 mm处平均肿瘤细胞凋亡率分别为(67.74±3.33)%、(56.36±3.63)%、(20.71±1.11)%,与B组、D组相比差异有统计学意义(P<0.01),与A组相比差异无统计学意义(P>0.01)。结论 RFA和骨水泥均可促进肿瘤细胞凋亡,RFA杀伤肿瘤范围更大,RFA联合骨水泥对肿瘤杀伤作用无明显增强。Objective To investigate the killing effect of radiofrequency ablation （RFA） combined with polymethylmethacrylate （PMMA）injection on paravertebral VX2 tumor in experimental rabbits. Methods The paravertebral VX2 tumor model was successfully established by using CT-guided puncture inoculation of VX2 tumor in 48 rabbits. The rabbits were equally and randomly divided into 4 groups with 12 rabbits in each group. Rabbits of group A received RFA first, which was followed by subsequent injection of 0.Sml PMMA. Rabbits of group B received injection of 0.5 ml PMMA only. Rabbits of group C received RFA only. Rabbits of group D （ used as the control group ） only received injection of 0.5 ml saline. All the experimental rabbits were sacrificed 24 hours after the treatment, and in each rabbit 4 pieces of 2 mm sized tissue were taken from the tumor center or separately taken from 4 different sites, that were 5, 10, 15 and 20 mm away from PMMA edge, in order to test the tumor cell apoptosis index. Results Technical success rate was 91.7% （11/12） in all group A, B and C, and in group D the technical success ratewas 100%. In group A and C, large patchy coagulation necrosis of tumor cells was observed within 10 mm range from the tumor center, the cells lost their morphology, and almost no apoptosis could be detected. In group A, the mean tumor cell apoptosis rates at the sites 10, 15 and 20 mm away from PMMA edge were （69.48 ± 1.27）%, （59.05±3.02） % and （21.03±2.20）% respectively, which was （10.25±0.79）% in group D; the difference between group A and group D was statistically significant （P〈0.01）. In group B, the mean tumor cell apoptosis rates at the sites 5, 10 and 15 mm away from PMMA edge were （62.52±2.07）%, （45.07±3.14）% and （ 17.41± 1.12）% respectively, and the difference between group B and group D was statistically significant （P〈 0.01） ; the mean tumor cell apoptosis rate at the site 20 mm away from PMMA edge was （11.15±0.97）%, which was not significantly

关 键 词：聚甲基丙烯酸甲酯 射频消融 兔 VX2肿瘤 凋亡 

分 类 号：R738.1[医药卫生—肿瘤]