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目的 探讨高强度聚焦超声 (high intensityfocusedultrasound ,HIFU)体外破坏原发性肝癌(HCC)的病理学变化。方法 HIFU治疗 5 6例HCC患者 ,6例患者治疗后外科手术切除肿瘤 ,观察其病理学变化。结果 在光镜下 ,HIFU治疗区和非治疗区边界清楚 ,治疗区内肿瘤细胞核出现固缩、碎裂或溶解等不可逆性细胞损伤现象 ,血窦结构塌陷 ,内皮细胞受损严重 ,靶区边缘有新生肉芽组织形成 ,逐渐修复坏死组织。在电镜下 ,肿瘤细胞、细胞器和细胞核出现明显损伤 ,细胞膜、核膜连续性丧失 ,核碎裂 ,细胞浆内出现大小不等的小泡样结构。结论 HIFU体外治疗HCC是安全、有效和可行的。
Objective To investigate the pathological changes of primary liver cancer (HCC) in vitro by high intensity focused ultrasound (HIFU). Methods HIFU was used to treat 56 HCC patients. Six patients were treated by surgical resection and their pathological changes were observed. Results Under light microscope, the boundaries between the treated and non-treated areas of HIFU were clear, and the nucleus of the tumor cells in the treated area appeared irreversible cell damage such as pyknosis, fragmentation or dissolution. The sinusoidal structure collapsed and the endothelial cells were severely damaged. There is a new granulation tissue formation and gradual repair of necrotic tissue. Under electron microscopy, tumor cells, organelles, and nuclei show significant damage, with loss of cell membrane and nuclear membrane continuity, nuclear fragmentation, and vesicle-like structures of varying sizes within the cytoplasm. Conclusion HIFU is safe, effective and feasible for the treatment of HCC in vitro.