射频凝固肝组织的酶组织化学研究

目的比较分析研究NADH（nieotinamide adenine dinucleotide）和HE（hematoxylin and eosin）染色评价射频治疗后即刻肝组织损伤。方法应用RF2000型射频治疗仪及LeVeen电极针，对5只实验猪肝脏进行射频消融，治疗后即刻取肝脏，分别行NADH和HE染色，评价肝组织坏死程度。结果HE染色射频消融中央区表现为核浓缩、胞浆红染，而核碎裂、核消失少见，肝细胞索完整，其细胞核形态和排列较消融前无明显改变。周边带表现为肝窦充血、出血。消融中央区、周边出血带和正常区之间界限模糊，难以准确评价射频消融的组织坏死程度，而NADH染色见消融中央区肝细胞完全失去活力，周边充血出血带肝细胞尚有活力，与正常区呈色截然不同，境界清晰，可准确、快速地对射频消融的肝组织坏死程度作出判断。结论射频是一种有效的肝癌治疗方法，HE染色不能准确评价射频消融对肝组织的即刻灭活效应，酶组织化学NADH染色判定细胞活力简易、直观、准确。

Enzymohistochemistry of liver after radiofrequency ablation

Objective To study the liver injury immediately after radiofrequency （RF） ablation by comparing nicotinamide adenine dinucleotide （NADH） and hematoxylin with eosin （HE） staining. Methods Radiofrequency ablation was performed on five pigs liver by using RF2000^TM radiofrequency generator and LeVeen Needle Electrode. Then livers were stained with NADH and HE separately to assess the degree of necrosis. Results HE staining showed pyknosis, e- osinophilic cytoplasm and integrated liver cell cord instead of karyorrhexis and karyolysis in central coagulation area after RFA treatment, while severe congestion and hemorrhage of hepatic sinus in peripheral zone. With obscure margin of ablation, it was hard to evaluate precisely thermally induced tissue necrosis. NADH staining showed no viable cells in the central ablation area, but existed viable cells in the congestion and hemorrhage area of the peripheral zone. It was totally different compared with normal tissue with clear margin. Conclusion HE can not be used to evaluate RFA efficiency immediately after treatment, while NADH immunohistological staining presents an accurate, convinent and simplistic approach for identifying radiofrequency-induced liver damage and cell viability.