Viable Tumor Tissue Adherent to Needle Applicators after Local Ablation: A Risk Factor for Local Tumor Progression
Viable Tumor Tissue Adherent to Needle Applicators after Local Ablation: A Risk Factor for Local Tumor Progression
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DOI：
10.1245/s10434-011-1762-8
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发表时间：
2011-12-01
影响因子：
3.7
通讯作者：
van Gulik, Thomas M.
中科院分区：
文献类型：
--
作者：
Snoeren, Nikol;Huiskens, Joost;van Gulik, Thomas M.
背景局部肿瘤进展（LTP）是恶性肝脏肿瘤局部消融术后的严重并发症，对患者生存率产生负面影响。LTP可能是治疗肿瘤消融不完全的结果。在这项研究中，我们确定了消融后附着在针头上的存活肿瘤细胞是否与LTP和无病生存率相关。在这项前瞻性研究中，收集了96名连续患者的组织，这些患者因130例肝脏恶性肿瘤接受了局部肝脏消融术。使用葡萄糖-6-磷酸脱氢酶染色和H&E染色切片的自发荧光强度水平分析附着于针施用器的细胞和组织的活力。随访至病情进展。26.7%的患者在局部消融后在施针器上发现了活的肿瘤细胞。所用的针头施用器的类型、开放性方法和省略轨道消融与粘附到针头施用器上的存活肿瘤组织显著相关。活细胞的存在是LTP的独立预测因子。活细胞附着于针头施源器与LTP的时间较短相关。26.7%的患者在消融后发现粘附在针头施用器上的活肿瘤细胞。活细胞粘附在针头施用器上的一个独立风险因素是遗漏了轨道消融。我们建议仅使用具有跟踪消融功能的RFA器械。局部消融后肿瘤细胞粘附在施针器上是LTP的独立危险因素。
Background. Local tumor progression (LTP) is a serious complication after local ablation of malignant liver tumors, negatively influencing patient survival. LTP may be the result of incomplete ablation of the treated tumor. In this study, we determined whether viable tumor cells attached to the needle applicator after ablation was associated with LTP and disease-free survival.Methods. In this prospective study, tissue was collected of 96 consecutive patients who underwent local liver ablations for 130 liver malignancies. Cells and tissue attached to the needle applicators were analyzed for viability using glucose-6-phosphate-dehydrogenase staining and autofluorescence intensity levels of H&E stained sections. Patients were followed-up until disease progression.Results. Viable tumor cells were found on the needle applicators after local ablation in 26.7% of patients. The type of needle applicator used, an open approach, and the omission of track ablation were significantly correlated with viable tumor tissue adherent to the needle applicator. The presence of viable cells was an independent predictor of LTP. The attachment of viable cells to the needle applicators was associated with a shorter time to LTP.Conclusions. Viable tumor cells adherent to the needle applicators were found after ablation of 26.7% of patients. An independent risk factor for viable cells adherent to the needle applicators is the omission of track ablation. We recommend using only RFA devices that have track ablation functionality. Adherence of viable tumor cells to the needle applicator after local ablation was an independent risk factor for LTP.