CAJ | 학술논문

目的初步研究氩氦刀冷冻消融治疗兔VX2肾癌的可行性、有效性与安全性.方法 2012年7月至2013年1月,将38只兔VX2肾癌模型采用随机数字表法随机分为3组:冷冻消融组(15只),根治性肾切除组(15只),肿瘤对照组(8只).冷冻消融组、根治性肾切除组分别在治疗前以及治疗后第1、7、14、21天测定SCr、BUN水平;冷冻消融组、肿瘤对照组于治疗后第21天行常规超声及超声造影观察肾肿瘤灶的大小、回声改变、血流状态;治疗后第21天处死实验兔,解剖尸体了解肿瘤转移情况并行病理染色. 结果 ①冷冻消融组治疗后第1天SCr、BUN明显升高,分别为(105.80±18.66) μmol/L、(8.52±1.04) mmol/L,与治疗前[(71.00±11.33) μmol/L、(6.69±0.78) mmol/L]比较差异有统计学意义(P＜0.05),第14天恢复至治疗前正常水平(P＞0.05);治疗后第21天,冷冻消融组SCr、BUN为(81.93±20.14) μmol/L、(7.00±0.56) mmol/L,与根治性肾切除组[(103.20± 16.16) μmol/L、(8.36±0.76) mmol/L]比较差异有统计学意义(P＜0.05).②治疗后第21天,冷冻消融组、根治性肾切除组肿瘤远处转移率分别为47％、40％,组间比较差异无统计学意义(P＞0.05);冷冻消融组肿瘤灶体积为(1.35±0.24) cm3,肿瘤对照组为(4.74± 1.69) cm3,组间比较差异有统计学意义(P＜0.05).③超声造影与组织病理学检查在冷冻消融治疗肾癌的肿瘤学疗效监测方面差异无统计学意义(P＞0.05).结论氩氦刀冷冻消融治疗兔VX2肾癌具有良好的可行性、安全性和有效性.超声造影是肾癌冷冻消融后近期疗效评价的重要手段.
목적 초보연구아양도냉동소융치료토VX2신암적가행성、유효성여안전성.방법 2012년7월지2013년1월,장38지토VX2신암모형채용수궤수자표법수궤분위3조:냉동소융조(15지),근치성신절제조(15지),종류대조조(8지).냉동소융조、근치성신절제조분별재치료전이급치료후제1、7、14、21천측정SCr、BUN수평;냉동소융조、종류대조조우치료후제21천행상규초성급초성조영관찰신종류조적대소、회성개변、혈류상태;치료후제21천처사실험토,해부시체료해종류전이정황병행병리염색. 결과 ①냉동소융조치료후제1천SCr、BUN명현승고,분별위(105.80±18.66) μmol/L、(8.52±1.04) mmol/L,여치료전[(71.00±11.33) μmol/L、(6.69±0.78) mmol/L]비교차이유통계학의의(P＜0.05),제14천회복지치료전정상수평(P＞0.05);치료후제21천,냉동소융조SCr、BUN위(81.93±20.14) μmol/L、(7.00±0.56) mmol/L,여근치성신절제조[(103.20± 16.16) μmol/L、(8.36±0.76) mmol/L]비교차이유통계학의의(P＜0.05).②치료후제21천,냉동소융조、근치성신절제조종류원처전이솔분별위47％、40％,조간비교차이무통계학의의(P＞0.05);냉동소융조종류조체적위(1.35±0.24) cm3,종류대조조위(4.74± 1.69) cm3,조간비교차이유통계학의의(P＜0.05).③초성조영여조직병이학검사재냉동소융치료신암적종류학료효감측방면차이무통계학의의(P＞0.05).결론 아양도냉동소융치료토VX2신암구유량호적가행성、안전성화유효성.초성조영시신암냉동소융후근기료효평개적중요수단.
Objective To study the feasibility,effectiveness and safety of cryoablation in renal VX2 tumor.Methods Thirty-eight rabbits with renal VX2 tumor in right kidney were randomized into 3 groups:cryoablation group,nephrectomy group and tumor control group (15,15 and 8 respectively).Vein blood was taken at the same time point for to investigate SCr and BUN in cryoablation and nephrectomy groups.The tumors were also evalutated by two-dimensional ultrasonography and contrast enhanced ultrasonography for the changes of the size,shape and the echo pre-treatment and post-treatment (21st day) in cryoablation and tumor control groups.Rabbits were sacrificed on the 21st day after the treatment,and the metastasis rates were compared.Results ①Significant differences were noted in favor of pre-treatment versus post-treatment with regard to SCr (71.00± 11.33 versus 105.80± 18.66 μmol/L,P＜ 0.05),BUN (6.69±0.78 versus 8.52± 1.04 mmol/L,P＜0.05) in cryoablation group,and the 2 indexes returned to pretreatment level on the 14th day after cryoablation (P＞0.05).There were significant differences between cryoablation group and nephrectomy group on the 21 st day in levels of SCr (81.93±20.14 versus 103.20± 16.16 μmol/L,P＜0.05) and BUN (7.00±0.56 versus 8.36±0.76 mmol/L,P＜0.05).②On the post-treatment day 21,there was no significant difference in the rate of metastasis in cryoablation group and nephrectomy group (47％ versus 40％,P＞0.05).The volume of the tumor in cryoablation group was significantly smaller than that in tumor control group (1.35±0.24 versus 4.74± 1.69 cm3,P＜0.05).③There was no significant difference in monitoring oncologic efficacy between contrast enhanced ultrasonography and pathologic examination (P＞0.05).Conclusions Cryoablation is an effective,safe and feasible therapy in treatment of rabbit renal VX2 tumor.Contrast enhanced ultrasonography can be used as an effective method to evaluate the therapeutic efficiency of cryoablation in renal tumor.