CAJ | 학술논문

目的探讨新型超声空化技术物理毁损肿瘤微血管的可行性并分析其病理机制.方法将24只皮下荷Walker-256肿瘤的SD雄性大鼠随机分成3组,超声微泡组(n=8)、单纯超声组(n=8)、假照组(n=8).实验中,在静脉注射剂量为0.2 ml/kg的脂质微泡超声造影剂配合下,同时用新型超声空化治疗仪辐照肿瘤3 min;单纯超声组以等量生理盐水代替微泡；假照组注射微泡而超声假照.各组治疗前、治疗后0 min对肿瘤进行高分辨力超声造影检查和分析.最后,获取肿瘤标本进行病理检查.结果超声微泡组治疗后,Walker-256肿瘤血流灌注完全消失,肿瘤造影平均灰阶值(GSV)由治疗前的121±12降为81±9(P＜0.01)；而假照组和单纯超声组治疗前后视觉血流灌注无明显变化,造影灰阶值分别为112±14和111±12,治疗后分别为(113±14) GSV和(103±13)GSV,两组治疗前后差异均无统计学意义(均P＞0.05).微泡超声空化治疗后,肿瘤微血管扩张、管壁结构崩解,弥漫性出血和组织水肿和局部血肿血栓形成.结论新型超声空化治疗技术能够毁损大鼠Walker-256肿瘤的微血管、阻断其微循环,可能成为一种新型的物理抗肿瘤血管生成方法.
목적 탐토신형초성공화기술물리훼손종류미혈관적가행성병분석기병리궤제.방법 장24지피하하Walker-256종류적SD웅성대서수궤분성3조,초성미포조(n=8)、단순초성조(n=8)、가조조(n=8).실험중,재정맥주사제량위0.2 ml/kg적지질미포초성조영제배합하,동시용신형초성공화치료의복조종류3 min;단순초성조이등량생리염수대체미포；가조조주사미포이초성가조.각조치료전、치료후0 min대종류진행고분변력초성조영검사화분석.최후,획취종류표본진행병리검사.결과 초성미포조치료후,Walker-256종류혈류관주완전소실,종류조영평균회계치(GSV)유치료전적121±12강위81±9(P＜0.01)；이가조조화단순초성조치료전후시각혈류관주무명현변화,조영회계치분별위112±14화111±12,치료후분별위(113±14) GSV화(103±13)GSV,량조치료전후차이균무통계학의의(균P＞0.05).미포초성공화치료후,종류미혈관확장、관벽결구붕해,미만성출혈화조직수종화국부혈종혈전형성.결론 신형초성공화치료기술능구훼손대서Walker-256종류적미혈관、조단기미순배,가능성위일충신형적물리항종류혈관생성방법.
Objective To explore the feasibility of disrupting tumor microcirculation by the cavitation of microbubbles enhanced ultrasound (US) and analyze its pathological mechanism.Methods Twenty-four SD male rats with subcutaneously transplanted Walker-256 tumor were divided into 3 groups,i.e.ultrasound plus microbubbles group (US + MB),US group and sham group.Pulsed US was delivered to tumor for 3 minutes during an intravenous infusion of microbubbles at 0.2 ml/kg in the US + MB group.The control groups received only the US exposure or the MB injection.Tumor perfusion was visualized with contrast enhanced ultrasound before and 0 ain after treatment.Finally the pathological examination was performed.Results The contrast perfusion of Walker-256 tumors vanished immediately after treatment in the US+ MB group and the gray scale value (GSV) decreased from 121 ±12 (pre-treatment) to 81 ±9 (posttreatment,P ＜0.01 ).There was no significant difference of GSV before and after treatment in two control groups (P ＞0.05).The GSV values were 112 ± 14 and 111 ± 12 pre-treatment and 113 ± 14 and 103 ± 13post-treatment in the sham and US groups.The pathological examination showed remarkable hemorrhage,endothelial injuries,increased intercellular edema and in situ thrombosis.Conclusion Microbubbleenhanced ultrasound can significantly disrupt tumor vasculature and block its circulation.And it may become a novel physical anti-angiogenetic therapy for tumor.