两种细胞辅助脂肪移植隆乳的临床效果观察

目的观察两种细胞辅助脂肪移植技术(Cell-assisted lipotransfer,CAL)隆乳的临床疗效。方法 CAL技术隆胸30例,根据术中提取的基质血管成分细胞(Stromal vascular fraction,SVF)来源分为两组,来源于脂肪组织的称为固相组(S组,n=24),来源于吸脂液的为液相组(L组,n=6)。术后均随访12个月。流式细胞仪检测两种来源SVF中脂肪干细胞(Adipose-derived stem cells,ADSCs)比例,MRI检测术前及术后6、12个月的乳房体积,计算移植脂肪组织的吸收率。结果两组新鲜分离的SVF细胞群中,ADSCs平均比例分别为S组40.73%、L组3.75%。MRI测量及统计结果显示,S组术后6、12个月时乳房体积均明显大于术前(P0.05)。12个月时脂肪吸收率为(51.83±15.28)%,与6个月时相比无明显差异(P>0.05);L组12个月时脂肪吸收率为(75.47±12.20)%,与6个月时相比无明显差异(P>0.05);MRI影像见囊肿2例,均来自S组。结论脂肪组织相比吸脂液,其SVF细胞群中ADSCs含量明显更高;CAL辅助脂肪移植技术隆乳术安全有效,术后6个月乳房体积即可保持基本稳定。

Evaluation on Two Kinds of Cell-assisted Lipotransfer for Breast Augmentation

Objective To evaluate the effect of two kinds of cell-assisted lipotransfer for breast augmentation. Methods Thirty patients accepted breast augmentation using cell-assisted lipotransfer （CAL）, and completed 12-month follow-up. According to the stromal vascular fraction （SVF） distilled from adipose tissue or aspirated liquid, the patients were divided into 2 groups：S group and L group. Flow-cytometry was used to detect the percentage of adipose-derived stem cells （ADSCs） in distilled SVF. The breast volumes and images were evaluated by MRI pre-operative, 6 and 12 months post-operative. The data of breast volume were marked and the resorption rate of transplanted adipose tissue was calculated. Results Averagely, the percentage of ADSCs in freshly distilled SVF in S group is 40.73% and 3.75% in L group. MRI showed that the breast volume 6-month post-operative and 12-month post-operative were both larger than that of preoperative in S group （P〈0.05）, while no significant difference between the breast volume 6-month post-operative and 12-month post-operative were observed （P〉0.05）, neither the resorption rate of 6 and 12-month post-operative （P〉0.05）, and the resorption rate of transplanted adipose tissue 12-month post-operative in S group was （51.83±15.28）%. However, there were no significant difference of breast volume among three time points in L group （P〉0.05）, neither the resorption rate of 6 and 12-month post-operative （P〉0.05）, and the resorption rate of transplanted adipose tissue 12-month post-operative in L group was （75.47±12.20）%. In addition, no calcification was seen in all MRI images but cysts were found in two cases of S group. Conclusion In process of breast augmentaion using cell-assissted lipotransfer, the distilled SVF from adipose tissue contains more ADSCs than that from aspirated liquid. The cell-assisted lipotransfer for breast augmentation is effective, safe, and the shrinkage stalls at 6-month post-operative.