射频消融治疗肝脏恶性肿瘤的临床价值  

Clinical Value of Radiofrequency Ablation in Treating Hepatic Malignant Tumor

作　　者：经翔[1] 丁建民[1] 杜智[1] 王毅军[1] 王凤梅[1] 王彦冬[1] 刘艳丽[1] 

机构地区：[1]天津市第三中心医院超声科,天津市300170

出　　处：《中国肿瘤临床》2009年第13期725-728,共4页Chinese Journal of Clinical Oncology

基　　金：天津市科技攻关计划重点专项基金(编号:05YFSZSF02500);天津市卫生局科技基金项目资助(编号:06KZ16)

摘　　要：目的:探讨射频消融(RFA)治疗肝脏恶性肿瘤的临床疗效及并发症。方法:对259例肝脏恶性肿瘤患者进行RFA治疗。肝细胞肝癌(HCC)223例行270人次的RFA,病灶总数372枚,平均1.4枚,肿瘤平均最大直径2.4±1.3cm,其中临床分期为Ⅰ期的61例;肝转移癌(MLC)36例行44人次的RFA,病灶总数72枚,平均1.6枚,肿瘤平均最大直径2.6±1.6cm。全组病例的治疗通过经皮穿刺和开腹两种途径。治疗原则为消融范围超过瘤周0.5～1.0cm。结果:RFA治疗后1个月行增强CT检查,HCC完全消融率97.3%(362/372),MLC完全消融率98.6%(71/72)。随访2～65个月,HCC局部复发率7.8%(29/372),1、3、5年生存率分别为87.7%、55.3%、32.9%,其中61例Ⅰ期HCC患者1、3、5年生存率分别为97.6%、86.1%、47.0%;MLC局部复发率11.1%(8/72),中位生存期16～24个月。HCC患者RFA的严重并发症发生率2.2%(6/270),MLC治疗中出现2例较严重的并发症。结论:RFA对于肝脏恶性肿瘤尤其HCC是一种有效的治疗手段,而且安全、并发症少,具有重要的临床价值。Objective： To study the effect of radiofrequency ablation （RFA） on hepatic malignant tumor and the relevant complications. Methods： A total of 259 patients who underwent RFA （314 procedures） were recruited. Two hundred and twenty-three cases of hepatocellular carcinoma （HCC） with 372 tumors received RFA （270 procedures）, and the average largest diameter of tumor was 2.4＋1.3 cm. Sixty-one cases of 223 patients were of stage Ⅰ. Thirty-six cases of metastatic liver carcinoma （MLC） with 72 tumors underwent RFA （44 procedures）, and the average largest diameter was 2.6± 1.6 cm. All patients were treated with RFA through percutaneous or open intraoperative approach. Results： Contrast enhanced CT was performed after RFA. The complete ablation rates were 97.3% （362/372） and 98.6% （71/72） for HCC and MLC, respectively. The patients were followed up for 2-65 months. The local tumor recurrence rate was 7.8% （29/372）. The 1-, 3-, and 5-year survival rates of HCC patients were 87.7%, 55.3%, and 32.9%, respectively. The survival rates for 61 stage Ⅰ HCC patients were 97.6%, 86.1%, and 47.0%, respectively. The local tumor recurrence rate was 11.1% （8/72）, and the median survival time was 16-24 months for MLC patients. The serious complication rate in HCC patients treated with RFA was 2.2% （6/270）. The serious complications occurred in 2 patients with MLC. Conclusion： IRFA is safe and effective for treating HCC, with fewer complications and great clinical value.

关 键 词：肝癌 射频消融 生存率 并发症 

分 类 号：R735.7[医药卫生—肿瘤]