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Brain and Nerve No to Shinkei Volume 40, Issue 4 （April 1988）

Brain and Nerve 脳と神経 40巻4号（1988年4月発行）

Japanese English

原著

脳腫瘍組織酸素分圧の研究 THE STUDY OF INTRATUMORAL PO₂ IN BRAIN TUMORS 嘉山孝正 ¹ , 小川彰 ¹ , 桜井芳明 ¹ , 和田徳男 ¹ , 村上衛 ² , 吉本高志 ³ , 鈴木二郎 ³ Takamasa Kayama ¹ , Akira Ogawa ¹ , Yoshiharu Sakurai ¹ , Tokuo Wada ¹ , Mamoru Murakami ² , Takashi Yoshimoto ³ , Jiro Sukuki ³ ¹国立仙台病院脳神経外科 ²国立仙台病院麻酔科 ³東北大学脳研脳神経外科 ¹Department of Neurosurgery,Sendai National Hospitol ²Department of Anesthesiology,Sendai National Hospitol ³Division of Neurosurgery,Institute of Brain Diseases, Tohoku University School of Medicine pp.319-325

発行日 1988年4月1日 Published Date 1988/4/1

DOI https://doi.org/10.11477/mf.1406206083

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Abstract 文献概要
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　抄録　未治療の脳腫瘍16例を対象として摘出術中に脳腫瘍内酸素分圧（TuO₂），脳腫瘍周囲脳組織酸素分圧（BrO₂）および動脈血中酸素分圧（PaO₂）を同時に測定し脳腫瘍内低酸素細胞の存在について検討した。16例の年齢は2歳から71歳に亘り平均41歳で，男女別では男性10例，女性6例であった。組織別には神経膠腫12例，転移性脳腫瘍4例であった。PaO₂およびTuO₂の測定は，ニードル型酸素分圧センサー（Kontron，モジュール　636）を用いBrO₂の測定には平板型酸素分圧センサー（Kontronモジュール632）を用いた。まず，ethrane麻酔下に吸入酸素：笑気率を1：3にするとPaO₂は109.2±5.8mmHgを示し，大気圧下，空気吸入時と比べやや高値であったが，同時に測定したTuO₂は15.3±2.3mmHg,BrO₂は59.8±6.5mmHgであった。即ち，TuO₂はBrO₂に比べ統計学的に有意の差を認め（P＜0.025）低値かつ酸素効果が影響する30mmHg以下であることも判った。従来より悪性腫瘍中低酸素細胞の存在はinvitroの実験を中心に間接的に推察されては来たが，直接酸素分圧を測定したものは臨床的には認められない。本研究はヒト脳腫瘍中低酸素域の存在を証明できたものと考える。

The aim of this study was to evaluate the hypoxic cells in the human brain tumor in vivo. Untreated 16 cases of brain tumor were analysed. During the surgery for the purpose of removal of the tumor, needle type-O₂ sensors were insert-ed into femoral artery and in brain tumor to measure PaO₂ and intratumoral O₂ pressure. A plate type O₂ sensor was put on the surface of surrounding brain cortex to measure cortical O₂ pressure. These O₂ sensors for this study is able to measure O₂ pressure continuously and to ob-serve these three O₂ pressure simultaneously. Operations were performed endtracheal anesthesiaunder inhalation of ethrane with maintaining sys-tolic blood pressure 120 mmHg. Setting the rate of O₂ and N₂O gas inhalation 1/3, PaO₂ revealed about 110 mmHg which is similar value as phy-siological state-1 ATM, air inhalation-. The value of TuO₂ and BrO₂ were revealed 15.3±2.3 (mean±SE) mmHg and 59.8±6.5 (mean±SE) mmHg. According to these results, it might be said that hypoxic fraction surely exist intra-tumoral tissue. It is also well known that O₂ re-moves from higher pressure zone to lower pres-sure zone after O₂ was diffused from red blood cell in brain tissue. It might be also mentioned that much lower hypoxic fraction than the value of this study is exististing intratumoral tissue.

It has long been recognized that hypoxia influ-ences the response of cells and tissues to radia-tion. However, they have been suspected on the basis of experimental data in vitro. This study showed hypoxic fraction in human brain tumor tissue in vivo.