重视病理性完全消融提高肝癌射频消融疗效  

The importance of pathological complete ablation on the efficacy of radiofrequency ablation in liver cancer

作　　者：孙文兵[1] 

机构地区：[1]首都医科大学附属北京朝阳医院西区肝胆外科,100043

出　　处：《中华肝胆外科杂志》2011年第3期182-185,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：基金项目：国家自然科学基金（30872490）;北京市卫生系统高层次卫生技术人才培养项目（2009-3-11）;吴阶平医学科研基金资助（320.6750.07131）

摘　　要：射频消融（RFA）已成为早期肝癌特别是肝细胞癌（HCC）潜在的治愈性手段。HCC的病理特点是主癌灶周围存在范围不等的微静脉浸润（MVI）区和卫星灶。RFA时，对主癌灶行完全消融，即便是有0．5～1．0cm的消融边界，获得的通常也只是影像学完全消融，残留的癌周MVI区和卫星灶会导致肿瘤复发，影响疗效；而对包括主癌灶、MVI区和卫星灶在内的所有肿瘤组织行完全消融，是病理性完全消融，可最大程度地预防肿瘤复发，这应该是RFA治疗HCC的理想目标。文章对局部治疗视角下HCC临床病理特点、RFA治疗HCC的机制以及获得病理性完全消融的策略进行了分析。Radiofrequency ablation （RFA） has been widely utilized as a potential curative treatment modality for hepatocellular carcinoma （HCC） of early stage. Pathologically, HCC is characterized by the peritumoral microvascular invasion （MVI） and satellite lesion of various scope. Complete ablation of the main tumor, even with a 0.5 -- 1.0 cm ablative margin, is usually only imaging complete ablation with residual of MVI and satellite lesion, which will grow and affect the therapeutic results. While complete ablation of all the tumor tissue, including the main tumor, peritumoral MVI and satellite lesion, is the pathological complete ablation with no residual of viable tumor cell, which should be the main target of RFA for HCC. This paper summarizes the clinicopathologieal characteristics of HCC in the perspective of locoregional therapy, the mechanism of RFA to treat HCC, and the common strategies to obtain pathological complete ablaiton.

关 键 词：肝细胞癌 射频消融 完全消融 残留 病理 

分 类 号：R735.7[医药卫生—肿瘤]