摘要
目的探讨化疗前后肝母细胞瘤(HB)瘤细胞的超微结构改变,评价放射介入化疗栓塞术在HB治疗中的作用。方法化疗前在B超或CT引导下经皮肝穿刺取肿瘤标本,延期手术时期再取标本,分别作普通光镜及电子显微镜检查,对比化疗前后的改变。结果化疗前可见瘤细胞核仁粗大深染,有丝分裂象多,间有大量胶原纤维或成纤维细胞样瘤细胞、畸形核、丰富的粗面内质网及线粒体;化疗后细胞异染色质边集、核固缩、碎裂,出现大量黑色溶酶体及大片坏死组织。结论①HB对化疗药顺柏等100%有较好的反应。②放射介入化疗栓塞术是HB术前化疗的有效方法,可提高肿瘤切除率。③胚胎型HB应增加术前化疗次数或考虑联合化疗。④血清AFP是判定疗效的可信指标。
Objective To investigate the ultrastructure chang of hepatoblastome cells before and after chemotherapy, to value the curative effect of hepatoblastoma by radio-interventional chemoembolization. Methods Samples were taken by direct puncture under ultrasound or CT scanning or during the operation. Then, light microscope and electron-microscope were used to observe it to find the difference before and after chemotherapy. Results Nucleoli become thicks,big and deep coloration and mitosis increases before chemotherapy. Meanwhile,there were many cells like collagen fibril or fiborblast, abnormal nucleoli with much more black lysosome and necrosis. Conclusions 1. chemotherapy by using cispliatin etc have good effect on hepatoblastoma. 2. Radical interventional chemoembolization is the first choice before the operation and can increase the rate of resection hepatoblastoma. 3. Embryonoid hepatoblastoma should be added the times of chemotherapy before the operation,and combined chemotherapy should considered. 4. AFP is believable marker in monitoring treatment outcome.
出处
《临床小儿外科杂志》
CAS
2004年第5期350-352,共3页
Journal of Clinical Pediatric Surgery
