超声微泡空化增强临床胰腺癌血流灌注的研究

目的：探讨超声微泡空化对晚期胰腺癌患者肿瘤病灶血流灌注的增强效应。方法：选取经病理组织学或细胞学证实的胰腺癌患者21例,在每次临床化疗结束后120 min（白蛋白紫杉醇联合吉西他滨、FOLFIRINOX 方案、白蛋白紫杉醇联合替吉奥）内对病灶进行超声微泡空化治疗,空化治疗前后分别行超声造影动态观察肿瘤血流灌注情况,并根据肿瘤区域时间-强度曲线,分析峰值强度、曲线下面积等指标。结果：21例胰腺癌患者共计84次化疗联合超声微泡空化治疗,空化治疗后胰腺癌病灶的峰值强度由109.19 ± 2.64增加到110.62 ± 2.70(P = 0.16),曲线下面积由4752.76 ± 149.53增加到4863.67 ± 159.77(P = 0.33),二者均无统计学意义。结论：超声微泡空化治疗可增加胰腺癌患者肿瘤病灶的血流灌注量,有望改善胰腺癌因乏氧、乏血供导致的化疗抵抗问题。

Sononeoperfusion excited by ultrasound and microbubbles in clinical pancreatic cancer

Objectives: To investigate the enhancement of tumor perfusion using microbubbles and diagnostic ultrasound in patients with advanced pancreatic cancer. Methods: Twenty-one patients diagnosed with advanced pancreatic cancer, confirmed by histopathology or cytology, were enrolled. The tumor regions were treated with diagnostic ultrasound combined with microbubbles within 120 min after each clinical chemotherapy (albumin paclitaxel combined with gemcitabine, FOLFIRINOX regimen, or albumin paclitaxel combined with S-1), the tumor perfusion was dynamically observed before and after the treatment by contrast-enhanced ultrasound respectively., The time-intensity curve (TIC) of the treated area was analyzed by post-processing software. And the peak intensity (PI) and area under curve (AUC) can be calculated automatically. Results: Twenty-one pancreatic cancer patients treated by a total of 84 chemotherapy sessions, combining with ultrasound-generated microbubble cavitation. The PI of pancreatic cancer lesions increased from 109.19 ± 2.64 to 110.62 ± 2.70 after cavitation (P = 0.16), the AUC increased from 4752.76 ± 149.53 to 4863.67 ± 159.77 (P = 0.33). Neither of them was statistically significant. Conclusion: The sononeoperfusion effect excited by diagnostic ultrasound and microbubbles has the potential to increase blood perfusion of pancreatic cancer lesions in the clinic.