射频消融治疗非手术适应证小肝癌疗效分析  

Therapeutic effect of radiofrequency ablation in unsuitable operative small hepatocellular carcinoma

作　　者：高文[1] 陈敏华[1] 严昆[1] 杨薇[1] 孙谊[2] 邢宝才[2] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院超声科,北京100036 [2]北京大学临床肿瘤学院北京肿瘤医院外科,北京100036

出　　处：《中国医学影像技术》2007年第2期254-257,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京市重大项目培育专项基金(Z000519004031);首都医学发展科研基金重点学科基金资助项目(ZD199909)资助。

摘　　要：目的评价超声引导下射频消融(RFA)作为治疗非手术适应证原发性小肝癌(SHCC)的临床疗效。方法53例≤3cm的HCC行超声引导下RFA,肿瘤平均大小2.5cm,同期行手术切除治疗的34例<3cm的HCC作为对照组。肿瘤平均大小2.6cm。回顾性分析RFA组与手术切除组治疗小肝癌的疗效及生存率。采用t检验及χ2检验分析两组间数值的差异性,用Kaplan-Meier法计算两组病例的生存率。结果平均生存时间RFA组为(54.9±3.8)个月,手术组为(55.6±5.0)个月;1、2、3、4年总生存率RFA组分别为95.9%、87.0%、74.5%和61.9%,手术组为94.1%、87.8%、75.3%和70.7%(P=0.743);1、2、3年无瘤生存率分别为RFA组82.8%、70.1%、57.5%,手术组85.1%、69.7%、57.1%;二者间均无明显差异(P=0.935)。RFA组3年以上总生存率较手术组略低;RFA组局部复发率为4.8%(4/84灶)。结论RFA因用时短、损伤小、并发症少等优势成为非手术适应证的SHCC病人的首选治疗方法,并可获得接近手术治疗的生存率。Objective To investigate the efficacy of （SHCC） which were unsuitable for surgery. Methods radiofrequency ablation （RFA） in small hepatoeellular carcinoma Fifty-three patients with HCC 43 cm underwent ultrasound guided RFA. The average size of tumor was 2.5 cm. At the same period, 34 patients with HCC 43 cm received surgical resection and were serviced as control group. The treatment efficacy and survival rate of SHCC between RFA group （n=53） and resection group （n= 34） was retrospectively analyzed. Statistical methods were Kaplan-Meier and t-test and chi-square test. Results The mean survival of RFA group was （54.9±3.8） month. The overall 1, 2, 3, 4 year survival rates of SHCC in RFA group were 95. 9%, 87. 0%, 74. 5% and 61. 9%, respectively, which in resection group were 94. 1%, 87. 8%, 75.3% and 70. 7% （P=0. 743）; And the disease-free survival rates in RFA group were 82.8%, 70.1% and 57.5%, respectively, which in resection group were 85.1%, 69.7% and 57.1%. There were no significant difference between the two groups. The local recurrence rate of RFA group was 4.8% （4/84 tumors）. In follow-up period, Eleven and 4 patients died in RFA group and resection group, respectively, due to liver failure （or tumor progression）. The complication rate in RFA group was significantly lower than that in resection group. Conclusion RFA could achieve the comparable efficacy to surgery in SHCC unsuitable for surgery. It could be used as safe and effective method to treat small HCC for its high survival rates, easy operation and mini-invasiveness.

关 键 词：射频消融 手术切除 原发性小肝癌 生存率 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]