納米刀 | NanoKnife

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胰腺癌-納米刀應用

肝癌-納米刀應用


納米刀腫瘤消融科技

納米刀腫瘤消融科技源於不可逆電穿孔科技,是一種非熱能的新型腫瘤消融科技,通過應用高壓短脈衝直流電穿透科技,改變跨膜電位以新增細胞膜通透性,從而導致細胞膜的脂質雙層結構形成納米級的不可逆電穿孔,能更精准地誘導消融區細胞凋亡,促進正常組織的再生與修復而對腫瘤進行完全的消融,且不會對消融區內的其他重要組織造成不可逆的損傷,適用於肝、肺、腎、胰腺、攝護腺以及其他實體腫瘤,尤其對靠近肝門區、膽囊膽管、胰腺、輸尿管、神經的腫瘤具有獨特優勢,其先進性、安全性和有效性已得到充分驗證。截止到2015年底,該設備已在歐美多個國家裝機近百臺,國內也有多家教學醫院進行了動物實驗研究和臨床驗證,其安全性和有效性受到國內外臨床專家的高度評價。

納米刀腫瘤消融科技的優勢:

1)消融時間短:治療直徑約3cm的實體腫瘤時,納米刀腫瘤治療一般只需90個100毫秒的超短脈衝。一組治療時間不到一分鐘。囙此即使有三個或四個相互重迭的消融區,全程的消融時間也不會超過5分鐘。治療結束後,如身體狀態好,當天或第二天即可出院。

2)治療區域的血管、膽管及神經等重要組織架構得以保留

傳統的消融管道,是以升溫或降溫的管道讓蛋白質發生變性,使得各類蛋白質和DNA均被破壞,病症區的結構便會遭到破壞無法修復。納米刀消融科技的另一個特點是它能够保護消融區內重要的組織結構。所有經過納米刀治療的肝組織中,其重要結構,如肝動脈,肝靜脈,門脈,肝內膽管不會造成永久性的不可逆傷害,故而均能得到良好的保護。

國外實驗證明,納米刀治療時只消融血管周圍組織而不會影響到結締組織的這種能力是獨特的,它的原理在於其不可逆電穿孔科技只破壞細胞膜,不會對組織中的其他結構或分子產生影響。而血管壁的各層結構由內皮細胞、平滑肌細胞、結締組織以及他們合成的彈性蛋白、膠原蛋白和其他細胞外基質成分組成。雖然不可逆電穿孔也會對血管平滑肌細胞產生一定影響,但由於其機制是僅破壞細胞膜,只對細胞產生作用,囙此不會破壞組織構架中其他類型的分子,仍然保持結締組織和血管細胞外基質的完好性,保持了血管基本的構架。另外,細胞外基質也為形成新的、健康的組織提供良好的支架。囙此該科技在治療血管、膽管及神經周圍的腫瘤時,對細胞施加微秒級的電脈衝,在細胞膜的磷脂雙分子層形成永久性的納米級空隙,從而導致細胞凋亡;在治療結束後,消融區的血管、膽管及神經仍然是完好的。而對於膽管而言,由於其結構復函更多的膠原結締組織和彈性纖維,而缺少不可逆電穿孔產生納米級空隙的正常細胞膜,從而不會影響到膽管的結構。

另外,該科技對消融區內的神經不會受到不可逆的傷害,是由於其蛋白質組成的結構不受不可逆電穿孔消融的影響,從而不會影響到基膜或神經內膜的完整性;而神經內膜與神經束膜保持完好,也為神經再生提供了條件。同時,神經小血管雖然會受到微小損傷,但能較快恢復,保證其內皮完整,從而保護了消融區的微脈管系統,也新增了神經再生的可能性。

3)不受熱池效應(有的稱為熱沉效應)或冷池效應的影響

納米刀的消融主要是通過電脈衝擊穿細胞膜,在此過程中不會產生熱量,也不會受到其他外界溫度影響。而傳統的熱消融或者冷消融,一旦消融區域記憶體在較大血管,其熱量就會被血流帶走,導致周邊消融不徹底,容易造成復發,而納米刀很好地避免了這個問題。

4)治療徹底,治療邊界清晰

納米刀消融的另一個優勢是,不管腫瘤所處的位置,尺寸大小以及形狀,它都能對腫瘤進行完整消融。此外,納米刀消融區邊界清晰,劃界厚度僅為1-2個細胞單元。治療區和非治療區域涇渭分明,囙此,對納米刀治療的有效性、治療結果以及後續跟踪都能進行更準確的判斷和評估。而其他像射頻或微波的消融管道,均會在消融區邊緣處出現“灰色區域”,即消融區的最週邊區域上還有大範圍沒完全滅活的腫瘤細胞。這是造成日後腫瘤復發的主要隱患之一,而納米刀治療不存在這一問題。

5)治療區域可恢復正常功能

傳統的消融模式是通過溫度讓組織發生蛋白質變性,繼而出現凝固性壞死,壞死後整個消融區裡的組織結構便不復存在。然後剩下對臟器有毒性的壞死組織,無法再恢復正常功能。相反,納米刀治療則是誘導腫瘤細胞出現凋亡。凋亡的優點之一就是它能够利用免疫來促進細胞死亡,人體將把細胞凋亡識別為正常的細胞死亡過程,然後通過細胞吞噬作用將凋亡組織清除掉,促進正常組織的再生與修復。

6)效果過程可即時監控

納米刀治療能够通過超聲、CT和MR進行影像導航和監控。在影像設備的輔助下,可以對納米刀探針的定位、標靶區域的消融過程以及最終消融區的大小進行即時監控,而且影像中消融區邊界的精確度可與組織學上的精確度相媲美。用超聲或CT監控到的消融區與病理分析中量測真實的消融區的尺寸偏差僅有幾毫米。由此可見,納米刀消融的影像監控的精確度非常高。影像中還能清楚顯示未消融的殘餘癌症細胞,於此醫生能够對其再次進行消融。另外,即時監控還可以讓醫生觀察到消融區周圍組織的變化,從而推斷出併發症出現的可能性,保障病人的安全以及有助於其術後快速恢復。

7)納米刀可適應更多複雜的病情

傳統的消融治療中,一旦腫瘤靠近大血管、靠近膽管、胰管、肝門靜脈等危險區域,則無法進行安全有效的治療,另外對於攝護腺腫瘤或者脊椎附近腫瘤,消融容易導致性功能喪失或神經受損而發生癱瘓等情况。由於納米刀不會對筦道結構和神經造成不可逆的損傷,對於上述提及的情况均能進行安全、精准而有效的治療,針對該類患者具有不可替代的作用。


If you have this disease, please follow your doctor's complete medical plan. You must consult the attending doctor before using the multidisciplinary rehabilitation plan. If your attending doctor does not recommend you to join the supplement conditioning combination, please do not use it. If you need to seek second opinion from other doctors, you can contact our online "Doctors Without Borders", or another professional doctor in your own city.

Liver cancer- Nanoknife application


Nanoknife tumor ablation technology

Nanoknife tumor ablation technology, originated from irreversible electroporation technology, is a new non thermal tumor ablation technology. Through the application of high-voltage short pulse DC penetration technology, the transmembrane potential can be changed to increase the permeability of cell membrane, resulting in the formation of lipid bilayer structure of cell membrane and irreversible electroporation at nanometer level, which can more accurately induce apoptosis in the ablation area and promote the normal group The regeneration and repair of the tumor can completely dissolve the tumor and will not cause irreversible damage to other important tissues in the ablation area. It is suitable for liver, lung, kidney, pancreas, prostate and other solid tumors, especially for tumors near the hilar region, gallbladder bile duct, pancreas, urinary canal and nerve, and its advanced, safe and effective has been filled. Sub validation. By the end of 2015, nearly 100 sets of the equipment have been installed in many European and American countries, and many domestic teaching hospitals have carried out animal experimental research and clinical verification, and its safety and effectiveness have been highly praised by clinical experts at home and abroad.

Advantages of nanoknife tumor ablation technology:

1) Short ablation time: in the treatment of solid tumors with a diameter of about 3cm, the nano knife tumor treatment generally only needs 90 100 millisecond ultrashort pulses. The treatment time of one group was less than one minute. Therefore, even if there are three or four overlapping ablation areas, the whole ablation time will not exceed 5 minutes. After treatment, if you are in good health, you can be discharged on the same day or the next day.

2) The blood vessels, bile ducts and nerves in the treatment area were preserved

The traditional way of ablation is to make proteins denatured by heating or cooling, so that all kinds of proteins and DNA are destroyed, and the structure of the disease area will be damaged and cannot be repaired. Another characteristic of nanoknife ablation technology is that it can protect the important tissue structure in the ablation area. In all liver tissues treated by nanoknife, its important structures, such as hepatic artery, hepatic vein, portal vein and intrahepatic bile duct, will not cause permanent irreversible damage, so they can be well protected.

The principle of nanoknife is that its irreversible electroporation technology only destroys the cell membrane and does not affect other structures or molecules in the tissue. Each layer of vascular wall is composed of endothelial cells, smooth muscle cells, connective tissue, elastin, collagen and other extracellular matrix components. Although irreversible electroporation can also affect vascular smooth muscle cells to a certain extent, its mechanism is only to destroy the cell membrane, only to affect the cells, so it will not destroy other types of molecules in the tissue architecture, and still maintain the integrity of connective tissue and vascular extracellular matrix, maintaining the basic vascular architecture. In addition, extracellular matrix also provides a good scaffold for the formation of new and healthy tissues. Therefore, in the treatment of tumor around blood vessels, bile ducts and nerves, microsecond electric pulses are applied to cells to form permanent nanoscale gaps in the phospholipid bilayer of cell membrane, leading to cell apoptosis; after the end of treatment, the blood vessels, bile ducts and nerves in the ablation area are still intact. For bile duct, the structure of bile duct will not be affected because of more collagen connective tissue and elastic fibers and lack of normal cell membrane which can produce nano space by irreversible electroporation.

In addition, the technique will not cause irreversible damage to the nerve in the ablation area, because the structure of its protein composition is not affected by irreversible electroporation ablation, so it will not affect the integrity of basement membrane or nerve endomembrane; and the integrity of nerve endomembrane and nerve bundle membrane also provides conditions for nerve regeneration. At the same time, although the small nerve vessels will be slightly damaged, they can recover quickly and ensure the integrity of their endothelium, thus protecting the microvascular system in the ablation area and increasing the possibility of nerve regeneration.

3) The influence of unheated pool effect (some are called heat sink effect) or cold pool effect

Nanoknife ablation is mainly through the pulse impact through the cell membrane, in this process will not produce heat, also will not be affected by other external temperature. Traditional thermal ablation or cold ablation, once there are large blood vessels in the ablation area, the heat will be taken away by the blood flow, resulting in incomplete peripheral ablation, which is easy to cause recurrence, and nanoknife can avoid this problem.

4) The treatment was thorough and the treatment boundary was clear

Another advantage of nanoknife ablation is that it can completely ablate the tumor regardless of its location, size and shape. In addition, the ablation area of nanoknife has a clear boundary, and the boundary thickness is only 1-2 cell units. The treatment area and non treatment area are distinct, so the effectiveness, treatment results and follow-up of nanoknife treatment can be more accurately judged and evaluated. In other ablation methods, such as radiofrequency or microwave, there will be a "gray area" at the edge of the ablation area, that is, there are a large range of tumor cells that are not completely inactivated in the most peripheral area of the ablation area. This is one of the main hidden dangers of tumor recurrence in the future, which does not exist in nanoknife treatment.

5) Normal function of the treated area was restored

The traditional ablation mode is to denature the tissue protein through temperature, and then coagulate necrosis occurs. After necrosis, the tissue structure in the whole ablation area no longer exists. Then, the necrotic tissue which is toxic to the organs is left, and the normal function can not be restored. On the contrary, nanoknife therapy can induce apoptosis of tumor cells. One of the advantages of apoptosis is that it can use immunity to promote cell death. The human body will recognize cell apoptosis as a normal process of cell death, and then remove the apoptotic tissue through cell phagocytosis to promote the regeneration and repair of normal tissue.

6) The effect process can be monitored in real time

Nanoknife therapy can be guided and monitored by ultrasound, CT and Mr. With the aid of imaging equipment, the positioning of nanoknife probe, the ablation process of target area and the size of the final ablation area can be monitored in real time, and the accuracy of the ablation area boundary in the image is comparable to that in histology. The size deviation between the ablation area monitored by ultrasound or CT and the real ablation area measured by pathological analysis is only a few millimeters. Therefore, the image monitoring accuracy of nanoknife ablation is very high. The image can also clearly show the remaining cancer cells that have not been ablated, so that doctors can ablate them again. In addition, real-time monitoring also allows doctors to observe the changes of tissue around the ablation area, so as to infer the possibility of complications, ensure the safety of patients and help them recover quickly after surgery.

7) Nanoknife can adapt to more complex conditions

In traditional ablation therapy, once the tumor is close to the big blood vessels, bile duct, pancreatic duct, hepatic portal vein and other dangerous areas, it can not be treated safely and effectively. In addition, for prostate tumors or tumors near the spine, ablation is easy to lead to the loss of sexual function or nerve damage and paralysis. Because nanoknife will not cause irreversible damage to the pipeline structure and nerve, it can provide safe, accurate and effective treatment for the above mentioned cases, and has an irreplaceable role for such patients.