微波在肝癌外科治疗实验和临床中的应用研究  

EXPERIMENTAL AND CLINICAL APPLIED STUDY ON THE MICROWAVE COAGULATION THERAPY FOR LIVER CANCER

作　　者：莫钦国[1] 梁安民[1] 袁卫平[1] 陈汉华[1] 唐朝晖[1] 赵荫农[1] 谢裕安[1] 罗元[1] 

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530021

出　　处：《肿瘤研究与临床》2002年第5期308-312,共5页Cancer Research and Clinic

基　　金：广西卫生厅计划课题基金资助项目 ( 9713)

摘　　要：目的 :探讨微波固化治疗肝癌的有效性、免疫效应及临床应用价值。方法 :1皮下接种 Hepa瘤细胞株建立小鼠肝癌模型 ,将 70只荷瘤小鼠随机分为 :微波固化 (MTC)组和对照组。 2单针微波固化 12只活体兔肝 ,观察肝功能变化。 3微波固化切除肝癌 45例 ,与同期传统方法切除肝癌40例作对照 ;微波固化不能切除的肝癌 2 0例与同期行肝动脉结扎合并肝动脉和门静脉双插化疗不能切除的肝癌 2 0例作对照。结果 :1MTC组小鼠肿瘤固化灶内癌细胞呈凝固性坏死 ,对照组肿瘤内有大量癌细胞存在。 2 MTC组癌旁组织内 CD+8和 CD+4 细胞的密度明显高于对照组。 3微波对肝脏功能有影响。4微波肝切除平均每例术中出血量比传统方法少 ,术后 3年复发率 31.1% ,而传统方法为 46 .3% ;微波固化不能切除肝癌组术后 3年生存率为 11.1% ,对照组 3年生存率为 10 .5 %。结论 :微波固化治疗肝癌是一种安全有效的方法 ,并且可促进固化灶周围组织的免疫反应 ;微波固化切除肝癌 ,止血效果好 ,并发症少 ,可减少切缘复发 。Objective:To explore the effect,the immune response and the value of clinical application of microwave tissue coagulation (MTC) therapy for hepatocellular carcinoma.Methods:①Implantable Hepa hepatoma model of mice were applied,seventy tumor-bearing mice were divided into two groups:MTC group and control group;②The liver tissue of twelve normal rabbits were inserted by single needle microwave antena for MTC,the changes of the liver function were observed;③45 cases with hepatocellular carcinoma (HCC) were treated by hepatectomy with MTC and compared with 40 cases with HCC treated by heaptectomy without using MTC.Another 20 cases with nonresectable HCC were treated by MTC and compared with 20 cases with nonresectable HCC treated by combining hepatic artery ligation with hepatic artery and portal vein infusion with anticancer agents at the same times.Results:①The carcinoma cells of the tumor in the coagulative region of mice got coagulation necrosis,however,there were lots of carcinoma cells in the control group.The quantity of CD + 8 and CD + 4 cells in the coagulative around tissue of MTC group was much higher than that of control group.Liver function was influenced easily after MTC.②In the 45 cases of hepatectomy with MTC,the average amount of bleeding was less than that in those of hepatectomy without using MTC.The 3-year recurrent rate was 31.1 % in the group of hepatectomy with MTC and 46.3 % in the group of hepatectomy without using MTC.The 3-year survival rates was 11.1 % in patients with nonresectable HCC treated by MTC and 10.5 % in thoese combined hepatic artery liagtion with hepatic artery and portal vein infusion with anticancer agents.Conclusion:The MTC treatment of liver carcinoma is a safe and effective method and the immune response of tumor surround was enhanced after MTC.It is suggested that hepatectomy with MTC can effectively reduce the amount of bleeding and recurrence of tumor at resected margin.

关 键 词：微波 肝癌 外科治疗 肝切除术 实验研究 临床研究 

分 类 号：R735.7[医药卫生—肿瘤]