【摘要】 目的　研究高强度聚焦超声 (HIFU)治疗乳腺癌后靶区肿瘤细胞的病理学变化和肿瘤细胞的凋亡 ,探讨HIFU治疗恶性实体肿瘤的机理。方法　 2 3例经病理学确诊的乳腺癌病人 ,在HIFU治疗后 1～ 2周行乳腺癌改良根治术。在每例切除的乳腺癌部位取材 ,应用HE染色和TUNEL方法观察HIFU治疗靶区内肿瘤细胞的病理学变化和肿瘤细胞的凋亡。结果　 2 3例病人HIFU治疗后靶区乳腺癌组织发生凝固性坏死 ,肿瘤组织浆浓缩 ,出现核固缩 ,核碎裂溶解 ,但未检测到凋亡染色阳性的肿瘤细胞。结论　HIFU通过引起肿瘤组织发生凝固性坏死而杀灭肿瘤细胞 ,这与肿瘤热疗有本质上的区别。更多还原

【Abstract】 Objective To investigate pathologic changes and apoptosis of breast cancer treated with high intensity focused ultrasound(HIFU)for its therapeutic mechanism in the treatment of malingnant carcinomas.Methods A total of 23 female patients with biopsy-proven breast cancer were enrolled in this study.They underwent HIFU treatment 1-2 weeks before modifiled radical mastectomy.After the operation,the specimen of removal breast cancer was collected,fixed in 10% neutral buffered formalin,and embedded in paraffin.HE staining and terminal deoxynucleotidyl transferase mediated dUTP nick-end-labeling (TUNEL)were performed to observe pathologic changes and to detect apoptotic tumor cells in the targeted breast cancer.Results HIFU caused complete coagulative necrosis of breast cancer in 23 patients.Distorted breast cancer cells with pyknotic nuclei and nuclei disappearance were observed in the target region.But no apoptotic tumor cells were detected with TUNEL method.Conclusion The mechanism of HIFU in the destruction of tumor is that HIFU causes coagulative necrosis of target tumor.There is a fundamental difference between HIFU and hyperthermia therapy in the mechanism of inducing tumor destruction.更多还原