巴氏法聯(lián)合高滲鹽水對(duì)骨與軟組織惡性腫瘤體外滅活研究
發(fā)布時(shí)間：2020-09-25 07:59
目的:探討20%高滲鹽水對(duì)體外腫瘤細(xì)胞的滅活作用及溫度、時(shí)間效應(yīng)關(guān)系,為臨床骨與軟組織惡性腫瘤進(jìn)行自體骨滅活再植保肢手術(shù)提供指導(dǎo)。方法:選取四肢及骨盆術(shù)前活檢確診為骨與軟組織惡性腫瘤患者24例,去除4例不符合條件病例,分三組分別在0.9%鹽水、20%高滲鹽水、巴氏法聯(lián)合高滲鹽水處理(15、30、45min),采用光鏡、透射電鏡觀察并計(jì)算腫瘤細(xì)胞滅活率。結(jié)果:20%高滲鹽水及巴氏法聯(lián)合法各時(shí)間點(diǎn)腫瘤細(xì)胞滅活較0.9%等滲鹽水存在明顯差異,差異有統(tǒng)計(jì)學(xué)意義(P0.01);巴氏聯(lián)合法15min優(yōu)于20%高滲鹽水組(P0.01)。結(jié)論:20%高滲鹽水滅瘤作用確切,聯(lián)合巴氏法或增加滅瘤時(shí)間能明顯增加腫瘤細(xì)胞壞死率,增加滅瘤時(shí)間至30min以上滅瘤效果達(dá)到最佳。
【學(xué)位單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位年份】：2018
【中圖分類】：R738.1;R738.6
【部分圖文】：
圖a 圖b 圖c圖1股骨遠(yuǎn)端離體骨肉瘤標(biāo)本a為股骨遠(yuǎn)端離體后骨肉瘤沿股骨縱軸中間劈開(kāi)大體圖片 b為股骨遠(yuǎn)端離體后骨肉腫瘤與骨腫瘤部分分離后大體圖片c為股骨遠(yuǎn)端離體后骨肉瘤將軟組織腫瘤與骨腫后均勻切成多部分后多點(diǎn)取材前大體圖片F(xiàn)ig.1 Specimens of isolated distal femur osteosarcomaA is a gross picture of distal femur osteosarcoma split along the middle of the longitudinal axis of tvitro osteosarcoma of the distal femur separates the soft tissue tumor from the bone tumor paosteosarcoma and c shows the distal femur osteosarcoma in vitro. Gross picture of soft tissue tumtumor after separating and evenly cutting into multiple parts and multiple points before sa2 滅活骨及軟組織腫瘤大體觀察生理鹽水各時(shí)間點(diǎn)組織無(wú)明顯變化，常溫下 20%高滲鹽組：軟組織表現(xiàn)為組織水腫、顏色變白，骨組織變化不明顯，65°20%高滲鹽水隨時(shí)組織腫瘤顏色表現(xiàn)出由弱到強(qiáng)的棕褐色，骨組織無(wú)明顯變化。
After immersing in 0.9% normal saline for 45 minutes, the results showed that the tumor cells were abnuclear chromatin was deeply stained and other malignant tumor features, and no obvious cell necfound. The nuclei were concentrated in the field of field of vision at room temperature 20% hyperosm15 minutes, and the nuclear chromatin was deeply stained. Some cell structures were vague and cocompletely distinguish whether necrotic or necrotic, nuclear concentration at room temperaturehyperosmotic salt for 30 minutes, cytosolic eosinophilic change, loose connective tissue shrinkage of Hnuclear concentration, nucleolysis and cytoplasmic acidophilic change at room temperature 20% hypsalt for 45 minutes. The loose connective tissue was further shrinked, the cytoplasm was denatured byG, the nucleus was concentrated, dissolved, the cytoplasm was denatured, the cell volume was reduce400. H, and the nucleus was condensed and dissolved at 30 minutes by the Pap combination methoddegeneration occurred in cytoplasm and cell volume was reduced. He ×400. I was found in the unstnecrotic area of the cells. The area of nuclear dissolution was enlarged in 45 min by Pap's combined ma wide range of bubble degeneration appeared in the cytoplasm, and the cell volume was redu4 電鏡下表現(xiàn)
細(xì)胞體積縮小，縮小細(xì)胞外圍�？梢�(jiàn)一圍繞細(xì)胞環(huán)狀空白區(qū)，細(xì)胞核及染色濃聚，細(xì)胞核染色質(zhì) HE 嗜堿性染色進(jìn)一步增強(qiáng)，胞漿嗜酸性染色增強(qiáng)，總細(xì)胞壞率為 82.77%，以核濃縮及裸核為主，核碎裂及核溶解較少。30 分鐘，腫瘤壞死為核濃縮，細(xì)胞胞漿嗜酸性變內(nèi)部胞核濃縮進(jìn)一步增強(qiáng)，且胞漿內(nèi)部出現(xiàn)空泡樣變性核碎裂及核溶解細(xì)胞出現(xiàn)嚴(yán)重破壞占比進(jìn)一步增多，總壞死 100%，部分腫瘤細(xì)胞構(gòu)模糊與對(duì)照細(xì)胞形態(tài)相似，但認(rèn)為細(xì)胞內(nèi)部已損傷、壞死，光鏡下無(wú)法辨別，電鏡進(jìn)一步證實(shí)。45 分鐘，細(xì)胞壞死仍以核濃縮為主，胞漿被 HE 染色嗜酸性進(jìn)步增強(qiáng)，內(nèi)部細(xì)胞核出現(xiàn)碎裂，約可見(jiàn)<3%片狀無(wú)法辨別的伊紅樣嗜酸性染色結(jié)構(gòu)總壞死率 100%。65℃20%高滲鹽 15 分鐘，腫瘤細(xì)胞仍以核濃縮壞死為主，核染質(zhì)嗜堿性增強(qiáng)，可見(jiàn) 5%腫瘤壞死呈片狀嗜酸性紅染樣溶解，總壞死率 92.03%。分鐘，細(xì)胞壞死以核濃縮及核碎裂為主，核碎裂及核溶解較 15 分鐘時(shí)進(jìn)一步增胞漿呈強(qiáng)嗜酸性改變并出現(xiàn)空泡樣改變，片狀結(jié)構(gòu)不清狀壞死進(jìn)一步增多，總壞率 100%，45 分鐘，細(xì)胞壞死以核濃縮及核碎裂為主，核碎裂及核溶解較 30 分鐘進(jìn)一步增多，部分細(xì)胞于核濃縮細(xì)胞內(nèi)可見(jiàn)白色空泡樣變化。總壞死率 100%。（圖 2）
【學(xué)位單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位年份】：2018
【中圖分類】：R738.1;R738.6
【部分圖文】：
圖a 圖b 圖c圖1股骨遠(yuǎn)端離體骨肉瘤標(biāo)本a為股骨遠(yuǎn)端離體后骨肉瘤沿股骨縱軸中間劈開(kāi)大體圖片 b為股骨遠(yuǎn)端離體后骨肉腫瘤與骨腫瘤部分分離后大體圖片c為股骨遠(yuǎn)端離體后骨肉瘤將軟組織腫瘤與骨腫后均勻切成多部分后多點(diǎn)取材前大體圖片F(xiàn)ig.1 Specimens of isolated distal femur osteosarcomaA is a gross picture of distal femur osteosarcoma split along the middle of the longitudinal axis of tvitro osteosarcoma of the distal femur separates the soft tissue tumor from the bone tumor paosteosarcoma and c shows the distal femur osteosarcoma in vitro. Gross picture of soft tissue tumtumor after separating and evenly cutting into multiple parts and multiple points before sa2 滅活骨及軟組織腫瘤大體觀察生理鹽水各時(shí)間點(diǎn)組織無(wú)明顯變化，常溫下 20%高滲鹽組：軟組織表現(xiàn)為組織水腫、顏色變白，骨組織變化不明顯，65°20%高滲鹽水隨時(shí)組織腫瘤顏色表現(xiàn)出由弱到強(qiáng)的棕褐色，骨組織無(wú)明顯變化。
After immersing in 0.9% normal saline for 45 minutes, the results showed that the tumor cells were abnuclear chromatin was deeply stained and other malignant tumor features, and no obvious cell necfound. The nuclei were concentrated in the field of field of vision at room temperature 20% hyperosm15 minutes, and the nuclear chromatin was deeply stained. Some cell structures were vague and cocompletely distinguish whether necrotic or necrotic, nuclear concentration at room temperaturehyperosmotic salt for 30 minutes, cytosolic eosinophilic change, loose connective tissue shrinkage of Hnuclear concentration, nucleolysis and cytoplasmic acidophilic change at room temperature 20% hypsalt for 45 minutes. The loose connective tissue was further shrinked, the cytoplasm was denatured byG, the nucleus was concentrated, dissolved, the cytoplasm was denatured, the cell volume was reduce400. H, and the nucleus was condensed and dissolved at 30 minutes by the Pap combination methoddegeneration occurred in cytoplasm and cell volume was reduced. He ×400. I was found in the unstnecrotic area of the cells. The area of nuclear dissolution was enlarged in 45 min by Pap's combined ma wide range of bubble degeneration appeared in the cytoplasm, and the cell volume was redu4 電鏡下表現(xiàn)
細(xì)胞體積縮小，縮小細(xì)胞外圍�？梢�(jiàn)一圍繞細(xì)胞環(huán)狀空白區(qū)，細(xì)胞核及染色濃聚，細(xì)胞核染色質(zhì) HE 嗜堿性染色進(jìn)一步增強(qiáng)，胞漿嗜酸性染色增強(qiáng)，總細(xì)胞壞率為 82.77%，以核濃縮及裸核為主，核碎裂及核溶解較少。30 分鐘，腫瘤壞死為核濃縮，細(xì)胞胞漿嗜酸性變內(nèi)部胞核濃縮進(jìn)一步增強(qiáng)，且胞漿內(nèi)部出現(xiàn)空泡樣變性核碎裂及核溶解細(xì)胞出現(xiàn)嚴(yán)重破壞占比進(jìn)一步增多，總壞死 100%，部分腫瘤細(xì)胞構(gòu)模糊與對(duì)照細(xì)胞形態(tài)相似，但認(rèn)為細(xì)胞內(nèi)部已損傷、壞死，光鏡下無(wú)法辨別，電鏡進(jìn)一步證實(shí)。45 分鐘，細(xì)胞壞死仍以核濃縮為主，胞漿被 HE 染色嗜酸性進(jìn)步增強(qiáng)，內(nèi)部細(xì)胞核出現(xiàn)碎裂，約可見(jiàn)<3%片狀無(wú)法辨別的伊紅樣嗜酸性染色結(jié)構(gòu)總壞死率 100%。65℃20%高滲鹽 15 分鐘，腫瘤細(xì)胞仍以核濃縮壞死為主，核染質(zhì)嗜堿性增強(qiáng)，可見(jiàn) 5%腫瘤壞死呈片狀嗜酸性紅染樣溶解，總壞死率 92.03%。分鐘，細(xì)胞壞死以核濃縮及核碎裂為主，核碎裂及核溶解較 15 分鐘時(shí)進(jìn)一步增胞漿呈強(qiáng)嗜酸性改變并出現(xiàn)空泡樣改變，片狀結(jié)構(gòu)不清狀壞死進(jìn)一步增多，總壞率 100%，45 分鐘，細(xì)胞壞死以核濃縮及核碎裂為主，核碎裂及核溶解較 30 分鐘進(jìn)一步增多，部分細(xì)胞于核濃縮細(xì)胞內(nèi)可見(jiàn)白色空泡樣變化。總壞死率 100%。（圖 2）
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 王俊江;田征;;高滲鹽水在惡性骨腫瘤治療中的應(yīng)用[J];中華醫(yī)學(xué)雜志;2016年11期
2 許宋鋒;劉江;聶鑫;于秀淳;徐明;王冰;鄭凱;付志厚;宋若先;劉曉平;;酒精滅活瘤段骨在重建惡性骨腫瘤骨缺損中的應(yīng)用[J];中國(guó)骨與關(guān)節(jié)雜志;2015年05期
3 張漓
本文編號(hào)：2826456
本文鏈接：http://www.sikaile.net/yixuelunwen/waikelunwen/2826456.html
最近更新
教材專著
