微泡诱导的超声空化联合凝血酶原阻塞肝肿瘤微循环增强局部热消融作用的研究

Currently, the ultrasound-guided local thermal ablative therapies provide effective local treatment for liver tumors in a minimally invasive fashion. Most importantly, improvements of thermal ablation for liver tumors are the key elements which not only improve the cure rate and efficacy, but reduce the risk of residual and recurrent tumors. With the aim of reducing heat sink effects and achieving effective energy accumulation, we try to improve the efficacy of local thermal ablation for VX2 liver tumor in rabbits after obstruction of tumor microcirculation by combined use of microbubble-enhanced ultrasonic cavitation with prothrombin in this study. Subsequently, the efficacies of thermal ablation including high intensity focused ultrasound, radiofrequency ablation and laser thermal ablation techniques for VX2 liver tumor were evaluated through imaging, morphology, pathology and molecular biology analysis. Overall, our study will represent an alternative approach for enhancements of local thermal ablation for minimally invasive treatment of both benign and malignant tumors including liver tumors.

超声引导的肿瘤局部热消融治疗，是治疗肝癌的新型微创技术。增强热消融效应是提高肝癌热消融治愈率和疗效，减少术后肿瘤残余和复发的关键所在。本项目以降低热消融中的热沉效应并达到能量有效蓄积为出发点，将微泡增强的超声空化联合凝血酶原诱发肿瘤微循环阻塞，并验证其对于兔肝VX2肿瘤局部热消融效应的增强作用。以高强度聚焦超声、射频和激光消融技术为例，通过影像学、形态学、病理学、分子生物学等综合指标进行评价，旨在为增强肿瘤局部热消融效应提供新的方法，为包括肝肿瘤在内的良、恶性肿瘤微创治疗提供了新的思路。

超声引导的肿瘤局部热消融治疗，是治疗肝癌的新型微创技术。增强热消融效应是提高肝癌热消融治愈率和疗效，减少术后肿瘤残余和复发的关键所在。本项目以降低热消融中的热沉效应并达到能量有效蓄积为出发点，证实了微泡诱导的超声空化联合血凝酶可在促进兔肝肿瘤内皮损伤的同时形成微血栓，使肿瘤局部血流量减少，进而减少热沉降效应的作用，达到明显增大肝肿瘤热消融范围的作用。该方法可使消融区域细胞组织结构破坏更为彻底，明显提高了微波、激光热消融的效率。我们同时还对热消融后消融区凝固性坏死、过渡区细胞凋亡、增殖，及周边组织的机化、修复和纤维包裹等生物学效应及转归等方面进行了分析。为增强肝脏风险位置肿瘤热消融效果提供新的有效及安全的治疗方法。