离体猪肝胆道内射频消融时毗邻胆道热休克蛋白70表达情况

摘要

Objective To study the expression of heat shock protein 70 ( HSP70) in biliary of adjacent ablation area while catheter radiofrequency ablation ( RFA) in ex-vivo porcine liver biliary under different power parameters. Methods Fifteen fresh ex-vivo porcine liver bile duct systems ( gallbladder and common bile duct preserved) filled with human bile were divided into 3 group ran-domly. Then, the RFA catheter was inserted into the hilar biliary through the common bile duct. All the ablation time were 120 s, the power of 10 W, 12 W, and 14 W were used for each group respec-tively. The expression of HSP70 in biliary of 1 cm,2 cm away from the distal pole were examined by immunohistochemical S-P method. Results ①The expression level of HSP70 in biliary of 1 cm a-way from the distal pole showed 4 cases in the first stage ( 26. 7％) , 6 in second stage ( 40％) , and 5 in third stage (33. 3％); The expression level of HSP70 in biliary of 2 cm away from the distal pole showed 10 cases in the first stage ( 66. 7％) , 4 in second stage ( 26. 7％) , and 1 in third stage (6. 6％);②The HSP70 expression level in biliary of 1cm away from the pole showed a positive cor-relation with the RFA power ( r=0. 755, P<0. 001) . Rank sum test showed statistical difference be-tween the HSP70 expression level in biliary of 1 cm and 2 cm away from the distal pole ( Z=-2. 334, P<0. 05) . Conclusion The HSP70 expression in biliary of adjacent RFA area could be induced by the catheater RFA. More HSP70 expressed with increased power while no more HSP70 expression were found in biliary of 2 cm away from the distal pole.%目的 探讨采用不同功率胆管内射频消融时,毗邻消融靶区的胆管组织热休克蛋白(heat shock protein,HSP)70表达的差异及意义.方法 15个新鲜离体猪肝随机分为3组(胆囊及胆总管中上段完整保留),将收集的人胆汁注入猪肝胆道系统内,然后将射频消融导管经胆总管引入肝门区胆管内.所有猪肝均消融120 s,第1、2、3组分别采用10 W、12 W、14 W功率消融.消融后取距远端消融电极1 cm、2 cm处胆管组织,采用免疫组化S-P法检测15例猪肝共30例胆管组织中HSP70的表达.结果 ①距远端消融电极1 cm处胆管组织HSP70表达:1级染色4例(26.7％),2级染色6例(40％),3级染色5例(33.3％);距远端消融电极2 cm处胆管组织HSP70表达:1级染色10例(66.7％),2级染色4例(26.7％),3级染色1例(6.6％);②消融区毗邻胆管(距远端消融电极1 cm)HSP70表达强度与消融功率呈正相关(r=0.755,P<0.001);距远端消融电极1 cm、2 cm处胆管组织HSP70表达强度差异有统计学意义(Z=-2.334,P<0.05).结论 胆管内射频消融可导致消融区毗邻胆管组织HSP70表达,随着消融功率的增加,毗邻消融区胆管组织内HSP70表达强度亦随之增加;远离消融区域胆管(距离远端消融电极≥2 cm)HSP70表达无明显增多.