【作者】 周立霞； 杨天祝；

【Author】 Zhou lixia* Yang tianzhu department of medical radiology,the 2nd Hospital of Hebei Medical University.Shijiazhuang 050011,China

【机构】 河北医科大学第二医院医学影像科； 河北医科大学神经生物研究室；

【摘要】 目的伽玛刀对于胶质瘤的治疗效果肯定,疗效发生过程中胶质瘤细胞内的超微结构变化如何,细胞间质中是否有炎性细胞的参与,都有待探讨。本研究即通过建立大鼠脑胶质瘤模型,对其进行伽玛刀照射,采用电子显微镜对胶质瘤细胞治疗前后的超微结构变化进行观察,从形态学角度探讨胶质瘤伽玛刀疗效。方法选择成年SD大鼠40只,随机分为对照组和治疗组。将传代培养的C6胶质瘤细胞接种于大鼠的右侧尾壳核,接种数量为1*106个。接种后15天,对治疗组大鼠进行伽玛刀照射,照射前1.5T MRI增强T1WI扫描定位,Gamma Plane计划系统设定治疗计划,给与肿瘤边缘剂量35GY。对照组放置于治疗室相同时间。伽玛刀照射后48h、7d、14d、21d对两组大鼠经心灌注固定后,超薄切片后,行透射电镜观察并记录、照相。结果 (1)对照组胶质瘤细胞排列密集,核大、浆少,细胞核占据细胞大部分,多为畸形核。胞浆内细胞器如粗面内质网较少,游离的核糖体丰富,提示合成功能旺盛。(2)治疗组伽玛刀治疗后48h,肿瘤细胞核畸形明显改善,胞浆所占比例上升,粗面内质网明显增多。可见部分凋亡细胞,表现为细胞核固缩,染色质边集呈典型半月状。治疗后7d、14d,凋亡细胞增多,部分细胞坏死,表现为核碎裂,胞膜溶解。细胞间质内嗜酸性粒细胞出现。治疗后21d,部分细胞核畸形明显,仍可见嗜酸性粒细胞。结论通过观察脑胶质瘤伽玛刀治疗前后的细胞超微结构变化,发现伽玛刀照射可导致治疗细胞凋亡。并且阻碍了肿瘤细胞的增殖和代谢。但是治疗后存在肿瘤细胞坏死,间质内嗜酸性粒细胞出现,提示存在免疫炎性反应。是否为脑水肿的产生原因,有待探讨。更多还原

【Abstract】 Objective:To investigate the therapeutic efficacy of Glioma treated with Gamma Knife by electron microscope,observe the tumor cell ultramicrostructure changes and inflammatory cell infiltration within the interstitial substance after therapy.So the rat glioma models were established,then acceped Gamma Knife treatment.Transmission electron microscope was applied to observed the tumor cell morphology influence.Methods:40 adult SD rats were divided into control and treatment group randomly.C6 glioma cells serial subcultivated were planted into the rats’ right caudate putamen nuclus,the cells total number was 1*106.15 days after cell planted,each rat in treatment group was received Gamma Knife radiotherapy.Before irradiation,enhanced MRI scanning was performed for accurate localization of the glioma,therapy plan was carried with Gamma Plan workstation.35Gy margin dose was delivered to the tumor. Rats in the contral group was standed within the treatment room for equal time.On the 48h,7d,14d,21d after Gamma Knife treatment,the two group were perfused and fixed0Ultrathin sections of the brain glioma were produced and transmission electron microscope used for ultramicrostructure observation and microscope photographed.Results:(1 )The contral group:glioma cells were karyomegaly and anisotrophy with rich chromatin,cytoplasm occupy less proportion, rough endoplasmic reticulum was less and free ribosome were rich,which suggested productive synthesis function. (2) The treatment group:48h after Gamma Knife irradiation,In the glioma cells,most of the anisotrophy nuclei were recovery,cytoplasm proportion increased,and rough endoplasmic reticulum also grow in number.Some cells tended to apoptosis,they appeared such as pyknosis of the nuclei,chromatin margination into crescent-shaped type.On 7d,14d after treatment,the apoptosis cells increased,and cell necrosis also exited as nuclear fragmentation and cell membrance dissolve.Acidophilic granulocytes were appeared among intercellular substance.On 21d group,some of the tumor cell nuclei get more irregular.Conclusion:The ultramicrostructures were influenced after Gamma Knife irradiation,and cell apoptosis may be a type of effect of thetreatment.inflammatory reaction also taken part in the therapy response and may play a role in the brain tissue edema.更多还原