射频消融与无水酒精注射治疗术后复发肝细胞癌患者的疗效比较  

Comparative study of radiofrequency ablation and percutaneous ethanol injection in treating postoperative recurrence of hepatocellular carcinoma

作　　者：张佐炳[1] 刘静[1] 方苇[1] 

机构地区：[1]厦门大学附属第一医院超声科,福建厦门361003

出　　处：《临床肝胆病杂志》2013年第8期588-590,共3页Journal of Clinical Hepatology

摘　　要：目的对比肝细胞癌(HCC)术后复发肿瘤病灶经射频消融(RFA)与无水酒精(PEI)注射治疗的疗效,以期为临床治疗HCC肿瘤复发提供参考。方法回顾性分析2007年8月至2010年1月HCC术后单一病灶复发患者175例,分为PEI治疗101例与RFA治疗74例。所有病例治疗前后均行常规彩超和超声造影/增强CT检查,观察比较治疗次数、病灶完全灭活率及治疗并发症发生率,记录患者治疗后1、2、3年生存率。计量资料采用t检验,计数资料采用χ2检验。结果 HCC术后复发病灶,平均每例的PEI治疗次数多于RFA(P<0.05),PEI和RFA治疗并发症的发生率比较差异无统计学意义(P>0.05);肿瘤直径<2.0 cm的HCC术后复发病灶组中,PEI和RFA治疗病灶完全灭活率比较差异无统计学意义(P>0.05),而2.0～5.0 cm HCC术后复发病灶组,PEI治疗病灶完全灭活率低于RFA,差异均有统计学意义(P<0.05)。HCC术后复发病灶直径<2.0 cm组中,PEI和RFA治疗术后1、2、3年生存率分别为89.1%和90.2%、69.1%和70.7%、49.1%和53.7%,两种治疗方式术后生存率比较差异无统计学意义(P>0.05)。而2.0～5.0cm组中,PEI和RFA治疗术后1、2、3年生存率分别为63.0%和84.8%、43.5%和66.7%、21.7%和45.5%,两种治疗方式术后生存率比较差异均有统计学意义(P<0.05)。结论肿瘤直径小于2.0 cm HCC术后复发病灶的RFA和PEI局部消融治疗,患者术后的生存率无明显差异,而肿瘤直径2.0～5.0 cm时,RFA治疗后生存期优于PEI。Objective To compare the clinical effects of radiofrequency ablation（RFA） and percutaneous ethanol injection（PEI） in treating postoperative recurrence of hepatocellular carcinoma（HCC） and to provide reference for clinical treatment of recurrent HCC.Methods A retrospective analysis was performed on the clinical data of 175 patients who had a single recurrent lesion after surgical treatment of HCC from August 2007 to January 2010.These patients were divided into PEI group（n=101） and RFA group（n=74） according to the modalities of treatment for recurrent HCC.All cases underwent color Doppler ultrasound and contrast-enhanced ultrasound or CT before and after treatment.The two groups were compared in terms of number of treatments,complete ablation rate,and complication rate.The 1-,2-,and 3-year survival rates after treatment were also recorded.The measurement data were subjected to t-test,while the enumeration data were subjected to chi-square test.Results The PEI group had a significantly larger mean number of treatments than the RFA group（P0.05）.There was no significant difference in complication rate between the two groups（P0.05）.For the recurrent lesions smaller than 2.0 cm in diameter,the complete ablation rate showed no significant difference between the RFA group and PEI group（P0.05）,while this rate was significantly higher in the RFA group than in the PEI group for the recurrent lesions with a diameter of 2.0-5.0 cm（P0.05）.Among the patients with recurrent lesions smaller than 2.0 cm in diameter,those receiving PEI had 1-,2-,and 3-year survival rates of 89.1%,69.1%,and 49.1%,respectively,versus 90.2%,70.7%,and 53.7% for those receiving RFA（P0.05）;among the patients with recurrent lesions with a diameter of 2.0-5.0 cm,those receiving PEI had significantly lower 1-,2-,and 3-year survival rates than those receiving RFA（63.0% vs 84.8%,P0.05;43.5% vs 66.7%,P0.05;21.7% vs 45.5%,P0.05）.Conclusion RFA and PEI lead to similar survival rates in patients with recurrent lesions s

关 键 词：癌 肝细胞 乙醇 注射 病灶内 射频消融 

分 类 号：R735.7[医药卫生—肿瘤]