Histopathological changes associated with high intensity focused ultrasound (HIFU) treatment for localised adenocarcinoma of the prostate
Histopathological changes associated with high intensity focused ultrasound (HIFU) treatment for localised adenocarcinoma of the prostate
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DOI：
10.1136/jcp.53.5.391
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发表时间：
2000-05-01
影响因子：
3.4
通讯作者：
van de Kaa, CA
中科院分区：
文献类型：
--
作者：
Van Leenders, GJLH;Beerlage, HP;van de Kaa, CA
Aims-Investigation高强度聚焦超声（HIFU）后前列腺癌患者的前列腺切除术标本的组织病理学变化和HIFU治疗后组织损伤的免疫组化标记物的鉴定。Methods-Nine例诊断为前列腺癌的患者在根治性前列腺切除术前7 ~ 12天接受单侧HIFU治疗。对切除标本进行组织学分析。免疫组化染色和电子显微镜进行了更微妙的表型changes.Results-All前列腺切除术标本显示，以及有限的HIFU病变的前列腺叶治疗的背侧。HIFU损伤中心的大多数上皮腺体显示坏死迹象。没有明显坏死特征的腺体也位于HIFU损伤中，这引起了是否发生了致命破坏的问题。该上皮细胞与泛细胞角蛋白、前列腺特异性抗原（PSA）和Ki 67抗体反应，但不表达细胞角蛋白8，这表明细胞严重损伤。超微结构检查显示细胞膜和细胞质细胞器解体，与细胞坏死一致。HIFU治疗是不完整的腹侧，侧，和背侧的前列腺lobetured. Conclusions HIFU治疗诱导光谱的形态学变化，从明显的光镜下坏死到更微妙的超微结构细胞损伤。所有的HIFU损伤都以细胞角蛋白8的丢失为标志。HIFU不会影响整个治疗区域，只会在前列腺的腹侧、侧部和背侧留下重要组织。
Aims-Investigation of the histopathological changes in prostatectomy specimens of patients with prostate cancer after high intensity focused ultrasound (HIFU) and identification of immunohistochemical markers for tissue damage after HIFU treatment.Methods-Nine patients diagnosed with adenocarcinoma of the prostate underwent unilateral HIFU treatment seven to 12 days before radical prostatectomy. The prostatectomy specimens were analysed histologically. Immunohistochemical staining and electron microscopy were performed to characterise more subtle phenotypic changes.Results-All prostatectomy specimens revealed well circumscribed HIFU lesions at the dorsal side of the prostate lobe treated. Most epithelial glands in the centre of the HIFU lesions revealed signs of necrosis. Glands without apparently necrotic features were also situated in the HIFU lesions, raising the question of whether lethal destruction had occurred. This epithelium reacted with antibodies to pan-cytokeratin, prostate specific antigen (PSA), and Ki67, but did nor express cytokeratin 8, which is indicative of severe cellular damage. Ultrastructural examination revealed disintegration of cellular membranes and cytoplasmic organelles consistent with cell necrosis. HIFU treatment was incomplete at the ventral, lateral, and dorsal sides of the prostate lobe treated.Conclusions-HIFU treatment induces a spectrum of morphological changes ranging from apparent light microscopic necrosis to more subtle ultrastructural cell damage. All HIFU lesions are marked by loss of cytokeratin 8. HIFU does not affect the whole area treated, leaving vital tissue at the ventral, lateral, and dorsal sides of the prostate.