超声监视下不同能级微波消融甲状腺肿瘤的疗效对比研究

目的筛选甲状腺肿瘤细胞凋亡的低能级微波消融参数,探讨低能级微波消融甲状腺肿瘤的安全性及有效性。方法建立裸鼠皮下甲状腺未分化癌模型,随机分为12组进行不同功率的微波消融。在消融前后分别进行超声造影,评估消融效果;术后24 h取肿瘤组织行HE染色观察病理变化,TUNEL及流式细胞仪凋亡检测法检测肿瘤组织凋亡坏死情况。结果HE染色显示微波消融可诱导肿瘤组织发生凋亡与坏死,随着消融功率的增加,肿瘤组织中凝固性坏死区域增加。TUNEL结果示8W组凋亡指数明显高于0W、5W、6W、7W组(P<0.01);8W组与9W、10W、11W、12W、13W、14W、15W组凋亡指数相比无差异(P>0.05)。流式细胞仪检测结果示,8W组存活率明显低于0W、5W、6W、7W组(P<0.01),而8W组与9W、10W、11W、12W、13W、14W、15W组存活率相比无差异(P>0.05)。结论超声引导下低能级微波消融治疗甲状腺肿瘤是有效及安全。

Comparative Study of Ultrasound-guided Microwave Ablation of Different Energy Levels in the Treatment of Thyroid Tumors

Objective To screen the lowest microwave energy level parameters for thyroid tumor cell apoptosis,and to investigate the safety and efficacy of low-energy microwave ablation of thyroid tumors.Methods Established anaplastic thyroid carcinoma model in mice and randomly divided into 12 groups for microwave ablation of different powers.Contrast-enhanced ultrasound was performed before and after ablation to evaluate the efficacy of ablation.After 24 hours of ablation,the pathological changes of tumor tissue were observed by HE staining,apoptosis and necrosis of tumor tissue were detected by TUNEL and flow cytometry.Results HE staining showed that microwave ablation can induce apoptosis and necrosis of tumor tissue,and with the increase of ablation power,the coagulative necrosis area of tumor tissue increased.TUNEL showed that the apoptosis index of the 8 W group was significantly higher than that of 0 W,5 W,6 W and 7 W group(P<0.01).There was no difference in apoptosis index between 8 W group and 9 W,10 W,11 W,12 W,13 W,14 W,15 W group(P>0.05).The result of flow cytometry showed that the survival rate of tumor cells in the 8 W group was significantly lower than that of 0 W,5 W,6 W and 7 W group(P<0.01),while there was no difference between 8 W and 9 W,10 W,11 W,12 W,13 W,14 W,15 W group(P>0.05).Conclusions Ultrasound-guided low-energy microwave ablation is effective and safe in the treatment of thyroid tumors.