射频消融联合瘤内注射无水乙醇治疗肝肿瘤的实验研究  

Radiofrequency Ablation Combined with Ethanol Injection for Liver Cancer Treatment——An Experimental Study

作　　者：张耀军[1] 陈敏山[1] 李锦清[1] 张亚奇[1] 钟崇[1] 梁惠宏[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2006年第9期1092-1096,共5页Chinese Journal of Cancer

基　　金：广东省科委社会攻关基金(No.2002C31107);广州市科委科技攻关基金(No.2002Z3-J20182)~~

摘　　要：背景与目的:射频消融(radiofrequencyablation,RFA)被认为是目前肝癌治疗中最为有效和最具前景的局部治疗手段之一,广泛应用于原发性和继发性肝癌的治疗中,而消融范围有限、复发率高是其主要缺点,因此国内外的研究主要集中于如何提高RFA的范围、降低复发率。本研究目的是探讨RFA与瘤内无水乙醇注射(percutaneousethanolinjection,PEI)联合应用能否提高单针消融的范围,及其产生的消融灶的大小、形态特征,并分析其联合方式。方法:应用离体猪肝和兔VX2肝肿瘤模型分别进行PEI、RFA、RFA-PEI、PEI-RFA,比较各组消融灶的大小、体积、形态特征,消融参数和副作用。结果:离体实验PEI-RFA组的消融范围明显大于PEI、RFA、RFA-PEI组(分别为2.05cm×2.35cmvs.0.63cm×1.45cm,1.58cm×1.94cm,1.63cm×2.02cm;P<0.05);PEI-RFA组消融体积较大[(6.33±2.86)cm3vs.(0.33±0.18)cm3,(3.21±1.18)cm3,(3.67±1.58)cm3,P<0.05];类圆率更接近于1.0(0.87vs.2.36,0.82,0.80),PEI组与其他三组相比差异有显著性(P<0.05)。活体实验PEI-RFA组的消融范围明显大于PEI、RFA、RFA-PEI组(1.92cm×2.22cmvs.1.00cm×1.56cm,1.17cm×1.55cm,1.23cm×1.64cm,P<0.05);PEI-RFA组消融体积较大[(5.26±2.22)cm3vs.(0.93±0.61)cm3,(1.60±0.87)cm3,(1.90±1.15)cm3,P<0.05];类圆率更接近于1.0(0.87vs.1.61,0.75,0.75,P<0.05)。结论:RFA前先行PEI(PEI-RFA)可以明显提高RFA的单针消融范围和体积,而且产生的消融灶形态与临床上所常见的小肝癌形态更加符合。BACKGROUND ＆ OBJECTIVE： Radiofrequency ablation （RFA）, which is widely used in treating primary and secondary liver cancer, is regarded as one of the most effective and promising regional therapies to date. However, limited necrosis region and high local recurrence are the major disadvantages of RFA. Researches on RFA are mostly focused on how to widen necrosis regions and decrease local recurrence. This study was to investigate whether RFA combined with ethanol injection （PEI） would widen necrosis region. METHODS. Ex-swine and rabbit VX2 liver cancer models were used for in vitro and in vivo experiments, respectively. Four groups of each model were treated with RFA, PEI, RFA-PEI, and PEI-RFA, respectively. The size, shape, and volume of necrosis lesions, parameters （time and power） of RFA, and adverse events in the 4 groups were analyzed. RESULTS. In in vitro study, compared with those of groups PEI, RFA, and RFA-PEI, the mean size of necrosis regions in group PEI-RFA was significantly larger （2.05 cm×2.35 cm vs. 0.63 cm×1.45 cm, 1.58 cm× 1.94 cm, 1.63 cm×2.02 cm, P 〈0.05）; the mean volume was greater [（6.33±2.86）cm^3 vs. （0.33±0.18）cm^3, （3.21±1.18）cm^3, （3.67±1.58） cm^3; P 〈0.05], and the isoperimetric ratio （parallel diameter/vertical diameter） was closer to 1.0 （0.87 vs. 2.36, 0.82, 0.80; P 〈0.05）. In in vivo study, compared with those of groups PEI, RFA, and RFA-PEI, the mean size of necrosis regions in group PEI-RFA was significantly larger （1.92 cm×2.22 cm vs. 1.00 cm×1.56 cm, 1.17 cm×1.55 cm, 1.23 cm×1.64 cm; P〈 0.05）; the mean volume was greater E（5.26±2.22）cm^3 vs. （0.93±0.61） cm^3, （1.60±0.87）cm^3, （1.90±1.15）cm^3; P 〈0.05], and the isoperimetric ratio was closer to 1.0 （0.87 vs 1.61, 0.75, 0.75; P 〈0.05）. CONCLUSION, RFA following PEI （PEI-RFA） increases the size and volume of necrosis region significantly, and makes the shape of necrosis region more similar to that of small liver cancer.

关 键 词：射频消融 无水乙醇注射 肝肿瘤 疾病模型 VX2 

分 类 号：R735.7[医药卫生—肿瘤]