氩氦刀冷冻消融治疗脑胶质瘤的现状与展望

胶质瘤是中枢神经系统难治性肿瘤，冷冻消融治疗作为一种新兴的肿瘤治疗技术在胶质瘤治疗中的价值正逐渐被重视。本文回顾了大量文献，从病理及分子生物学角度总结了冷冻消融治疗胶质瘤的机制；通过众多临床病例分析了冷冻疗法的适用范围、临床疗效和存在的问题；基于国内外前瞻性研究展望了冷冻治疗胶质瘤的发展方向及前景。冷冻消融可以通过直接导致坏死和凋亡、改变局部微循环和调节抗肿瘤免疫等机制摧毁肿瘤细胞；在影像学技术实时监控下冷冻可以成为很好的手术辅助手段，现已取得了满意的临床效果；另外冷冻技术与化疗、放疗、免疫治疗等方法联合应用可更有利于发挥其治疗作用。随着冷冻设备的改进和冷冻技术的完善，冷冻消融将在胶质瘤治疗中占有重要的地位。 

Status and prospect of argon-helium cryosurgery system for the treatment of gliomas

Glioma is one of the most refractory tumors affecting the central nervous system. As a new technique, cryoablation has been considered for the treatment of glioma. Considering previous studies, we summarized the mechanism of cryoablation to treat glioma based on pathology and molecular biology perspectives. We also analyzed the indications, effects, and problems of cryoablation in clinical practice. Furthermore, we proposed that this technique may be used in future trends and applications. The mechanism of eradicating tumor cells by cryoablation involves the following: (1) using an ultralow temperature to induce necrosis and apoptosis; (2) changing the local microcirculation of tumors; and (3) adjusting anti-tumor immunity. As an alternative surgical treatment, cryoablation could improve the therapeutic effects by real-time medical imaging. Cryoablation combined with chemotherapy, radiotherapy, immunotherapy, and other methods could provide a more effective treatment for gliomas. Therefore, cryotherapy could be a possible treatment for glioma and become a sustained research field.