Pathologic changes after interstitial laser therapy of infiltrating breast carcinoma
Pathologic changes after interstitial laser therapy of infiltrating breast carcinoma
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DOI：
10.1016/s0002-9610(01)00732-2
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发表时间：
2001-10-01
影响因子：
3
通讯作者：
Assad, L
中科院分区：
文献类型：
--
作者：
Bloom, KJ;Dowlat, K;Assad, L
背景：间质激光治疗（ILT）是一种通过热能破坏肿瘤细胞的技术。先前的研究表明，该程序是安全和有效的，在实验室动物和完整的细胞死亡，四唑蓝染色评估，实现在激光treated area.Design：四十名妇女与本地化，乳房X线检查可检测到的，T1乳腺癌同意与ILT治疗，然后有治疗区随后切除。延迟期为5至42天。在ILT之前，乳腺癌的诊断是通过立体定向针芯活检建立的。结果：所有40例患者都表现出特征性的大体外观，其中包括一系列的同心环周围的空腔对应的激光针尖。紧邻腔体的组织似乎凝固，并显示与烧灼伪影相同的“风扫”核。周围是一个白褐色的环，组织学上显示可识别的肿瘤。在苏木精-伊红切片上，该区域未观察到坏死、细胞凋亡增加或炎性浸润。尽管激光治疗区域外的上皮细胞染色强烈，但可识别的肿瘤细胞中细胞角蛋白的免疫染色呈阴性。接下来观察到一个组织学上由坏死肿瘤组成的红褐色组织环，该组织环被血管增生和脂肪坏死的边缘包围。脂肪坏死区以外的乳腺组织似乎不受激光治疗的影响。结论：ILT似乎是一种有效的方法来治疗小局限性乳腺癌。重要的是，病理学家认识到ILT后看到的机会，特别是含有假存活肿瘤的区域。细胞角蛋白可能是识别这些可能无法存活但可识别的肿瘤细胞的标志物。激光影响区域的范围由血管增生和脂肪坏死定义。(C)2001 Excerpta Medica，Inc. All rights reserved.
Background: Interstitial laser therapy (ILT) is a technique of destroying tumor cells via thermal energy. Prior studies have shown that the procedure is safe and efficacious in laboratory animals and that complete cell death, as assessed by tetrazollium staining, is achieved in the laser treated area.Design: Forty women with localized, mammographically detectable, Tl breast cancers consented to be treated with ILT and then have the treated area subsequently excised. The delay period ranged from 5 to 42 days. Prior to ILT, the diagnosis of breast carcinoma was established by stereotactic needle core biopsy.Results: All 40 cases showed a characteristic gross appearance, which consisted of a series of concentric rings surrounding a cavity corresponding to the laser needle tip. The tissue immediately adjacent to the cavity appeared coagulated and showed the same "wind-swept" nuclei seen with cautery artifact. Surrounding this was a white-tan ring that histologically showed recognizable tumor. No necrosis, increased apoptosis or inflammatory infiltrate was noted in this area on hematoxylin-eosin sections. Immunostains for cytokeratin were negative in the recognizable tumor cells despite intense staining in the epithelial cells outside the laser treated area. A ring of red tan tissue which histologic ally consisted of necrotic tumor was seen next and this, in turn, was surrounded by a rim of vascular proliferation and fat necrosis. The breast tissue outside the zone of fat necrosis appeared to be unaffected by the laser therapy.Conclusions: ILT appears to be an effective way to treat small localized breast cancer. It is important for the pathologist to recognize the chances seen after ILT, especially the zone containing pseudoviable tumor. Cytokeratin may be a marker to identify these likely non-viable but recognizable tumor cells. The extent of the laser affected area is defined by vascular proliferation and fat necrosis. (C) 2001 Excerpta Medica, Inc. All rights reserved.