摘要
目的通过细胞活性关键酶对热的反应，探讨微波消融治疗对甲状腺结节细胞活性的影响。方法对2017年11月至2018年2月在上海国际医学中心微创临床诊疗基地进行超声引导下微波消融治疗甲状腺结节的患者104例，年龄14～55岁，男42例、女62例，共120枚甲状腺结节在微波消融前和消融术后即刻分别对边缘域及过渡域进行粗针穿刺活检，所得标本分别进行HE染色法观察组织与细胞结构及酶组织化学法检测细胞内琥珀酸脱氢酶（SDH）和还原型烟酰胺腺嘌呤二核苷酸黄递酶（NADPH-d）活性，比较微波消融前后SDH和NADPH—d的活性变化并与组织结构所见平行对照。结果酶组织化学染色显示120枚甲状腺结节细胞内SDH及NADPH—d在微波消融前边缘域及过渡域阳性率均为100％，消融术后即刻边缘域及过渡域阳性率均为0％，消融前、消融后即刻相同区域SDH及NADPH—d酶组织化学染色阳性率差异有统计学意义（P〈0．05）。HE染色显示甲状腺结节消融前、后即刻均保持特征性组织结构与细胞形态，且无明显不同，120枚甲状腺结节消融后即刻取材病理诊断符合率100％。结论在评价甲状腺结节微波消融的短期疗效时，作为人体细胞活性关键酶SDH及NADPH-d的检测可以更快速、直观的反映细胞活性情况，不宜仅采用HE染色的组织结构与细胞形态学所见。
Objective To explore the effect of microwave ablation on thyroid nodules cell activity by the reaction of key enzyme of cell activation. Methods From November 2017 to February 2018, 104 patients with 120 thyroid nodules underwent ultrasound-guided microwave ablation at Super-minimally Invasive Medicals, Shanghai International Medical Center, aged 14 -55 years, 42 males and 62 females. Twice core needle biopsy were performed before and after thermal ablation. The specimen were using hematoxylin and eosin （HE） staining and enzyme histochemical staining with include succinate dehydrogenase （SDH） and nicotinamide adeninedinucleotide phosphate diaphorase （NADPH-d）, respectively, and observe under microscope. Results Enzyme histochemical staining showed that the positive rate of SDH and NADPH-d in the marginal region and transitional region were 100% before ablation, and were 0% immediately after ablation. The positive rate of SDH and NADPH-d histochemical staining in the same area before and immediately after ablation was statistically significant （P 〈 0. 05）. Shortly after microwave ablation, the tissue structure and cell morphology showed no obvious alteration in HE stained sections, but in sections with enzyme histochemical staining, the activity of SDH and NADPH-d in ablated tissue disappeared. The accuracy rate of pathologic diagnosis was 100% after ablation. Conclusions SDH and NADPH-d enzyme activity may be better in evaluating the short-term efficacy of microwave ablation of thyroid nodules than HE staining.
作者
章建全
闫磊
陈红琼
吴震中
Zhang Jianquan;Yan Lei;Chen Hongqiong;Wu Zhenzhong(Super-minimally Invasive Medicals,Shanghai International Medical Center,Shanghai 201210,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第43期3524-3527,共4页
National Medical Journal of China
基金
国家自然科学基金（81171436）
