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目的 :研究高强度聚焦超声 (HIFU)治疗后乳腺癌细胞代谢及生物学行为的变化。方法 :2 3例乳腺癌患者改良根治术前 1～ 2周接受 HIFU治疗。术后对乳腺癌组织行 :(1 ) NADH-黄递酶 (nicotinamide adenine dinu-cleotide- diaphorase)组织化学染色 ;(2 )用单克隆抗体 PCNA,CD44v6,MMP- 9行免疫组织化学染色 (SP法 ) ;(3)癌基因 C- erb B- 2 m RNA原位杂交 ;(4)端粒酶 TRAP- ELISA法行端粒酶活性进行测定。结果 :(1 ) HIFU治疗靶区内 NADH-黄递酶阴性 ,但靶区外未损伤区酶染色为阳性 ;(2 )对照组乳腺癌组织 PCNA指数、 CD44v6、 MMP-9阳性率分别为 44%、 56%和 60 % ,而 HIFU治疗组其靶区内细胞无 1例阳性 ;(3)对照组乳腺癌组织 C- erb B- 2 m R-NA阳性率为 36% ,而 HIFU治疗组其靶区内细胞无 1例阳性 ;(4)对照组乳腺癌组织端粒酶活性为 1 .87,HIFU治疗组其靶区内组织端粒酶活性为 0 .1 7,接近阴性对照 (P<0 .0 0 1 )。结论 :HIFU治疗靶区乳腺癌组织生长能力、侵袭转移能力丧失 ,端粒酶失活 ,癌基因 C- erb B- 2破坏或转录下降 ,经 HIFU治疗后乳腺癌组织是一团无任何功能的组织
Objective: To study the changes of metabolism and biological behavior of breast cancer cells after high intensity focused ultrasound (HIFU) treatment. METHODS: Twenty-three breast cancer patients underwent HIFU treatment 1 to 2 weeks prior to modified radical mastectomy. Postoperatively, breast cancer tissues were subjected to: (1) histochemical staining of NADH-diaphorase; (2) immunohistochemical staining with monoclonal antibodies PCNA, CD44v6 and MMP-9 Method); (3) in situ hybridization of oncogene C-erb B-2 m RNA; (4) telomerase activity by telomerase TRAP-ELISA. Results: (1) The positive rate of NADH-diaphorase in the target area of HIFU treatment was positive, but the enzyme staining was not significant in the non-target area; (2) The positive rates of PCNA index, CD44v6 and MMP-9 in control group were 44 %, 56% and 60%, respectively, while none of the cells in the target area of HIFU treatment group was positive. (3) The positive rate of C-erb B- 2 m R-NA in control group was 36% (4) The telomerase activity of breast cancer tissues in the control group was 1.87, and the telomerase activity in the target tissues of the HIFU treatment group was 0.17, close to that of the negative control (P <0 0 0 1). Conclusion: HIFU can reduce the growth of breast cancer cells, loss of invasion and metastasis, inactivation of telomerase, destruction of oncogene C-erb B-2 and decrease of transcription in HIFU-treated breast cancer tissues. After HIFU treatment, breast cancer tissue has no function organization