有核细胞净化器用于恶性肿瘤血液回收的安全性能研究

背景测定新型有核细胞净化器能否完全清除和破坏回收血液内的大量肿瘤细胞及其对红细胞的影响。方法选择临床拟行肝癌/胆囊癌根治术等患者20名,回收术中从切皮至肿瘤切除过程中的失血,洗涤后备用;同一患者被切除的肿瘤组织立即制成单细胞悬液,计数后加入回收血液内,再使用有核细胞净化器处理。分别测定处理前后血液内有核细胞、红细胞数量,并观察有核细胞的形态;免疫荧光染色法测定血液内肿瘤细胞和干细胞,细胞培养法测定血液内有核细胞的活性和增殖能力;取净化器膜作光镜检测。结果由肿瘤组织制成的细胞悬液具有较强的增殖活性;将(2.24±2.57)108个肿瘤组织细胞加入回收血液后,使有核细胞数量达(8.67±4.35)×108/200 m l,再取血标本分离有核细胞,85%的血液内培养出肿瘤克隆株,荧光染色可见CD133和AE1/AE3阳性,提示这些具有增殖能力的细胞可能为肿瘤干细胞;经有核细胞净化器处理后,红细胞回收率为(94.9±3.6)%,而细胞核计数下降4 log至(5.92±4.58)×105/L,显微镜下可见这些细胞核多为裸露细胞核,甚至细胞核也被破坏,细胞培养未发现1例有核细胞贴壁、生长;光镜检测显示第1层净化器膜上部黏附大量有核细胞,第2~15层未见完整有核细胞。结论即使手术过程中肿瘤细胞逸出的数量多达107~109个,有核细胞净化器依然能够完全清除或破坏逸出的肿瘤细胞,且不影响其红细胞回收率;因此有核细胞净化器能够满足肿瘤细胞大量逸出的情况而安全用于恶性肿瘤手术的血液回收。

The safety of karyocyte scavenger for intraoperative blood salvage during oncosurgery

Objective:To test the efficiency of the karyocyte scavenger by adding the cancer cells in the salvaged blood and its influence on erythrocyte.Methods Twenty patients suffering from hepatoma or gallbladder cancer,and were scheduled to tumorectomy were selected.Blood salvage was begun from skin incision to tumor removed.After the tumor was removed,tumor cell suspension was prepared at once.The cells were counted and added to the same patient's salvaged blood.Then the salvaged blood with added cancer cells was...