摘要
目的探讨淋巴结内植入放射性125I粒子治疗乳腺癌淋巴结转移的可行性及安全性,为该疗法进入临床应用提供实验依据。材料与方法选取健康成年新西兰大白兔25只建立乳腺癌腋窝淋巴结转移模型,22只建模成功,随机选取3只摘除肿大的淋巴结行病理学检查,证实其性质;将剩余19只兔随机分成实验组(n=10)和对照组(n=9),实验组淋巴结内植入具有放射性的125I粒子,对照组淋巴结内植入无放射性的空粒子,每周利用常规超声观察并测量腋窝淋巴结的最大直径。以对照组实验动物全部死亡作为实验终点,对实验动物进行尸检。结果 3枚淋巴结病理结果证实全部为转移性淋巴结。粒子植入第12周,实验组10只实验兔9只转移淋巴结直径减小,治疗有效(P<0.05);1只治疗失败,第8周时长径为3.28 cm,但增长较对照组缓慢(P<0.05),病理解剖发现粒子聚集。对照组实验兔全部死亡,肿大的淋巴结出现破溃,尸检鉴定肺转移5例、肺合并肝转移1例、肝转移2例、骨转移1例。两组淋巴结直径从第3周起差异有统计学意义(P<0.01)。整个实验过程除1例乳腺原位移植瘤复发行第2次切除后未再复发外,其他实验兔均未出现患侧上肢水肿、皮下水肿等并发症。结论淋巴结内植入放射性125I粒子治疗乳腺癌腋窝淋巴结转移安全、有效,有望应用于临床。
Purpose To study the feasibility and safety of implanting 125 I into lymph nodes, so as to provide experimental evidence for the clinical application of this therapy. Materials and Methods Twenty-five healthy adult New Zealand white rabbits were selected to establish the model. Among the 22 successfully established models, 3 rabbits were randomly selected to remove the lymph nodes for pathological examination; the rest 19 rabbits were divided into two groups randomly： the experimental group（n=10） and the control group（n=9）. Radioactive seeds 125 I were implanted into the lymph nodes of the experimental group while hollow seeds were implanted into the lymph nodes of the control group. The maximal diameter of lymph node was observed and measured by conventional ultrasonography weekly. An autopsy of the experimental animals was carried out as all the animals in the control group died as the study end points. Results The pathological examination showed that the 3 removed lymph nodes were all metastatic. In the 12 th week, 9 rabbits in the experimental group were found that the diameter of metastatic lymph nodes was reduced which suggested the treatment was effective（P〈0.05）; the treatment of one rabbit failed as the maximal diameter of the lymph node was 3.28 cm at 8th week but it still had a slower growth compared with the rabbits in control group（P〈0.05）. The pathological anatomy found that seeds were gathered. All of the rabbits in control group died and the lymph nodes began to ulcerate. The autopsy confirmed that there were five cases of lung metastasis, one combined with lung and liver metastasis, two combined with liver metastasis and one combined with bone metastasis. The difference of the diameter of lymph node began to show statistical significance between two groups since the 3rd week（P〈0.01）. In the whole experiment, none of the rabbits in the experimental group had complications such as upper limb edema and subcutaneous edema except one case of orthotopic transplantation tumor of breast cancer which had never relapsed after the second lymphadenectomy. Conclusion Implanting 125 I in lymph nodes to treat axillary lymph node metastasis of breast cancer seems safe and effective, which is hopeful to be applied into clinic.
出处
《中国医学影像学杂志》
CSCD
北大核心
2016年第9期654-657,共4页
Chinese Journal of Medical Imaging
关键词
乳腺肿瘤
淋巴转移
放射疗法
碘放射性同位素
疾病模型
动物
兔
Breast neoplasms
Lymphatic metastasis
Radiotherapy
Iodine radioisotopes
Disease models
animal
Rabbits
作者简介
通讯作者孙业全E-mail： sunyequan007@163.com
