氩氦冷冻消融治疗进展期肝癌的疗效及其影响因素研究  

Clinical effect and survival time of argon-helium cryoablation for hepatitis B-related advanced hepatocellular carcinoma:a pilot clinical study

作　　者：常秀娟[1,2] 陆荫英[2] 白文林[2] 陈艳[2] 安林静[2] 周霖[2] 吴煜[2] 王鋐[2] 楼敏[2] 苏淑慧[2] 杨永平[2] 

机构地区：[1]解放军军事医学科学院,北京100039 [2]解放军第三○二医院肝癌治疗研究中心

出　　处：《肝脏》2010年第1期11-14,共4页Chinese Hepatology

基　　金：国家重大专项基金资助项目(2008ZX10002-018);军队医学杰出人才基金资助项目(04J020)

摘　　要：目的探讨氩氦冷冻消融治疗乙型肝炎相关性进展期肝细胞癌(HCC)的临床疗效和影响生存期的因素。方法采用临床列队对照研究190例乙型肝炎相关性进展期HCC患者,其中147例行氩氦冷冻消融治疗,43例未行局部消融和肝动脉化疗栓塞治疗。结果氩氦冷冻消融乙型肝炎相关性进展期HCC患者生存期为10.11个月,未治疗者生存期仅为4.73个月,氩氦冷冻消融治疗进展期HCC严重肝损伤发生率为5.4%,Child-Pugh分级≥B8的病例占87.5%,胆红素水平>51.3μmol/L者占75%;在HBV相关性进展期HCC中,HBV DNA载量中、低水平占91%,HBeAg阴性患者占66.67%,两者与肿瘤细胞分化程度无关;肝硬化程度及肿瘤细胞分化程度是影响进展期HCC患者生存期的关键因素。结论冷冻消融治疗乙型肝炎相关性进展期HCC能显著延长患者的生存期,是影响进展期HCC生存期的独立因素;Child-Pugh分级≥B8,伴有胆红素水平>51.3μmol/L的进展期HCC患者不适宜行冷冻消融;肝硬化程度及肿瘤细胞分化程度是影响进展期HCC患者生存期的关键因素。Objective To evaluate the clinical effect and the survival time of percutaneous argon-helium cryoablation for hepatitis B-related advanced hepatocellular cancer.Methods One hundred and ninty patients（147 patients with cryoablated,43 patients without any ablation） with hepatitis B-related HCC were studied by means of clinical cohort.Results The survival time of patients with hepatitis B-related advanced HCC received cryoablation was 10.11 months.On the contrary the survival time was 4.73 months.The rate of the severity liver damaged of patiets who cryoablated was 5.4%（The rate of Child-Pugh score≥B8 was 87.5%,and the rate of serum bilirubin 51.3 μmol/ L was 75%）.The rate of low to moderate load of HBV DNA among patients with hepatitis B-related advanced HCC was 91%.The rate of HBeAg negative was 66.67%.Both of them were unrelated with tumor cell differentiation.Cirrhosis and tumor cells differentation were key factors of survival time of advanced HCC.Conclusion Croyablation can evidently prolongate over of the survival time of patients with hepatitis B-related advanced HCC.It is the independent factor which can influence the survival time.The patients with Child-Pugh score≥B8 and serum bilirubin 51.3 μmol/ L are not suitable for cryoablation.Cirrhosis and tumor cells differentation were key factors which influene the survival time of advanced HCC.

关 键 词：氩氦冷冻消融 慢性乙型肝炎 进展期肝细胞癌 生存期 

分 类 号：R735.7[医药卫生—肿瘤]