A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer.
A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer.
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DOI：
10.1038/sj.bjc.6601411
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发表时间：
2003-12-15
影响因子：
8.8
通讯作者：
Zhu, H
中科院分区：
文献类型：
--
作者：
Wu, F;Wang, Z-B;Cao, Y-De;Chen, W-Z;Bai, J;Zou, J-Z;Zhu, H
高强度聚焦超声（HIFU）是一种非侵入性治疗方法，可在完整皮肤的深处诱导肿瘤完全凝固性坏死。本研究旨在探讨高强度聚焦超声（HIFU）治疗局限性乳腺癌的可行性。共有48名经活检证实的乳腺癌（T1-2，N 0 -2，M0）女性被随机分配到对照组和HIFU组，对照组进行改良根治性乳房切除术，HIFU组进行体外HIFU消融乳腺癌，然后进行改良根治性乳房切除术。通过近期随访、组织病理学及免疫组化染色观察HIFU对肿瘤的治疗效果及并发症。结果表明，HIFU治疗的患者中未观察到严重的副作用。病理结果显示，HIFU治疗的肿瘤细胞发生完全凝固性坏死，肿瘤血管严重受损。免疫组化结果显示，HIFU组肿瘤细胞PCNA、MMP-9和CD 44 v6均未表达，表明HIFU组肿瘤细胞丧失了增殖、侵袭和转移的能力。结论：作为一种非侵入性治疗，高强度聚焦超声在局部乳腺癌的体外治疗中是有效、安全和可行的。
High-intensity focused ultrasound (HIFU) is a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin. This study was to explore the possibility of using HIFU for the treatment of patients with localised breast cancer in a controlled clinical trial. A total of 48 women with biopsy-proven breast cancer (T1–2, N0–2, M0) were randomised to the control group in which modified radical mastectomy was performed, and the HIFU group in which an extracorporeal HIFU ablation of breast cancer was followed by modified radical mastectomy. Short-term follow-up, pathologic and immunohistochemical stains were performed to assess the therapeutic effects on tumour and complications of HIFU. The results showed that no severe side effect was observed in the HIFU-treated patients. Pathologic findings revealed that HIFU-treated tumour cells underwent complete coagulative necrosis, and tumour vascular vessels were severely damaged. Immunohistochemical staining showed that no expression of PCNA, MMP-9, and CD44v6 was detected within the treated tumour cells in the HIFU group, indicating that the treated tumour cells lost the abilities of proliferation, invasion, and metastasis. It is concluded that, as a noninvasive therapy, HIFU could be effective, safe, and feasible in the extracorporeal treatment of localised breast cancer.