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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年06期

页码:

631-633

栏目:

临床医学

出版日期:

2019-11-20

文章信息/Info

Title:

Application of contrast-enhanced ultrasound in laparoscopic partial nephrectomy

文章编号:

1006-8147(2019)06-0631-03

作者:

李宁

（天津医科大学第二医院健康体检科，天津 300211）

Author(s):

LI Ning

（Health Physical Examination Center，The Second Hospital, Tianjin Medical University, Tianjin 300211,China）

关键词:

超声造影; 腹腔镜肾部分切除术; 精准切除

Keywords:

CEUS;  LPN;  accurate resection

分类号:

R699.2+R445.1

DOI:

-

文献标志码:

A

摘要:

目的：探讨超声造影在腹腔镜肾部分切除术中精准切除肿瘤的应用价值。方法：选取我院64例T1期肾癌患者作为研究对象并随机分为试验组（超声造影组）和对照组各32例。试验组T1a期21例，T1b期11例；对照组T1a期20例，T1b期12例。两组均于切缘（试验组肿瘤边距0.5cm，对照组肿瘤边距1.0cm）不同位置取3处组织进行活检，另对照组肿瘤边距0.5cm处再取3块同时送检，观察HE染色和PCNA、Bax蛋白表达。结果：两组切缘活检均未发现肿瘤细胞，对照组T1a期肿瘤边距0.5cm处活检4例共6处发现肿瘤细胞，肿瘤阳性率10.0%；T1b期3例共5处发现肿瘤细胞，肿瘤阳性率13.9%。T1a期和T1b期肿瘤中两组切缘PCNA、Bax阳性表达率均无显著差异，而对照组肿瘤边距0.5cm处活检PCNA阳性表达率显著高于切缘，Bax阳性表达率显著低于切缘。结论：应用超声造影指导腹腔镜肾部分切除术能够缩短手术切除边距同时提高癌灶切除完整性。

Abstract:

Objective: To evaluate the value of contrast-enhanced ultrasonography(CEUS) in the accurate resection of tumor via laparoscopic partial nephrectomy(LPN). Methods： 64 patients with stage T1 renal cancer in our hospital were selected and randomly divided into the experimental group(CEUS group) and the control group (32 cases each). There are 21 T1a and 11 T1b cases in experimental group and 20 T1a and 12 T1b cases in control group. Three kinds of tissue were taken for biopsy from different positions at the incisional margin (0.5cm in the experimental group and 1.0cm in the control group) of the two groups, and another three kinds of tissue were taken from 0.5cm tumor margin in the control group to perform the HE staining and observe the expression of PCNA and Bax proteins at the same time. Results： No tumor cells were found in the incisional margin biopsies of the two groups. In 0.5cm tumor margin of control group, tumor cells were found in 6 sites of 4 T1a patients with a positive rate of 10.0%.Tumor cells were found in 5 sites of 3 T1b patients with a positive rate of 13.9%. In T1a and T1b tumors, there was no significant difference in the positive expression rates of PCNA and Bax at the incisional margin between the two groups, while the positive expression rates of PCNA at the 0.5cm tumor margin of control group were significantly higher than the incisional margin, and the positive expression rates of Bax were significantly lower than the incisional margin. Conclusion： LPN guided by CEUS can shorten the surgical margin and improve the integrity of tumor resection.

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备注/Memo

备注/Memo:

作者简介 李宁（1984-），女，医师，硕士，研究方向：医学影像与放射治疗学，E-mail：55292109@qq.com。

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更新日期/Last Update: 2020-01-20