高强度聚焦超声治疗大鼠骨肉瘤的疗效观察

关键词：骨肉瘤 高强度聚焦超声 碱性磷酸酶

Keywords:osteosarcoma  high intensity focused ultrasound  alkaline phosphatase

摘要：

      目的：从病理学角度和血清生化水平观察高强度聚焦超声（HIFU）治疗SD大鼠骨肉瘤的效果。方法：将25只移植成功模型鼠随机分为5组，分别于治疗前、治疗后（即刻、第2d、第5d、第15d）取原位肿瘤、肺组织做光镜和电镜检查，同时采血清测碱性磷酸酶（ALP）水平。HIFU单点单次治疗时间为10s，总共治疗时间均为250s。结果：HIFU治疗后靶区肿瘤呈凝同性坏死，坏死区胞核碎裂、溶解消失，嗜酸染色增强。残存骨小梁中骨母细胞坏死消失，骨小梁结构尚保持。HIFU后15d．可见坏死区与正常交界边缘有肉芽组织形成，髓腔边缘可见间叶细胞增生并向软骨细胞分化，残存骨小梁中有细胞增生。HIFU治疗后模型鼠ALP水平比治疗前有明显降低（P〈0．05或P〈0．01），并且随时间推移逐渐呈下降趋势，但治疗后ALP仍高于正常水平（P〈0．01）。结论：HIFU治疗骨肿瘤效果显著。

Abstract:

      Objective:To observe the effect of high intensity focused ultrasound(HIFU) on treating SD rat osteosarcoma through pathological ways and biochemical indicator of blood.Method:Twenty five model rats were distributed into five groups, the tumor in situ and lung preparation in each group was obtained to be checked with light microscope and electron microscope before and after HIFU therapy(immediate, 2nd day, 5th day, 15th day). At the same time, serum alkaline phosphatase(ALP) was detected. The treatment time of HIFU groups were 250s, and their once treatment time was 10s.Result:The tumor of target area revealed coagulation necrosis after HIFU therapy. Karyorrhexis and karyolysis could be seen in the necrosis area and eosinostaining enhanced. The osteoblast was necrotic and disappeared in the remnant of bone trabecula. Granulation tissue began to repair at the boundary between necrotic area and normal area on the 15th day after HIFU therapy. Hyperplasia of lobus intermedius cells could be seen at the boundary of medullary cavity and it began to differentiate to cartilage cells. Cell hyperplasia could be seen in the remnant of bone trabecula. Compared with the untreated group, the ALP level was obviously decreased after HIFU therapy(P<0.05 or P<0.01), and gradually decreased in accordance with time. But the ALP level after HIFU therapy was still higher than normal level(P<0.01).Conclusion:The effect of treating osteosarcoma by HIFU is very notable.