手术部分肝切除与射频消融治疗多发肝细胞癌预后比较  

Effect of hepatic resection vs. radiofrequency ablation on multiple hepatocellular carcinoma

作　　者：邱宝安[1] 赵文超[1] 夏念信[1] 谭勇[1] 安阳[1] 祝建勇[1] 杨英祥[1] 刘鹏[1] 吴印涛[1] 王敬晗[1] 

机构地区：[1]海军总医院肝胆外科,北京100048

出　　处：《解放军医学院学报》2015年第3期226-229,共4页Academic Journal of Chinese PLA Medical School

基　　金：北京市科委"首都市民健康培育"项目(Z141100002114015)~~

摘　　要：目的比较部分肝切除术及射频消融术(radiofrequency ablation,RFA)对符合米兰标准的多发肝癌疗效。方法回顾性分析2007年6月-2013年12在我科接受治疗的140例肝功能良好、多发肝癌(符合米兰标准)的患者资料,其中接受部分肝切除术78例,接受RFA治疗62例,分别对术前主要检查结果、围术期并发症发生率、术后第3天肝功能指标及生存结果进行比较。结果手术组术后贫血、腹水及低蛋白血症的发生率总体上高于RFA组,术后第3天谷丙转氨酶及谷草转氨酶水平显著高于RFA组;1、2、3年生存率手术组分别为80.8%、60.3%、48.7%,RFA组分别为83.9%、48.0%、30.6%。手术组生存率优于RFA组(P=0.037)。1、2、3年无瘤生存率手术组分别为74.4%、47.4%、37.2%,RFA组分别为71.0%、38.7%、21.0%。手术组优于RFA组(P=0.007)。结论符合米兰标准、肝功能Child-Pugh A级的多发肝癌患者仍可能从外科切除中获益。Objective To compare the effect of surgical resection （SR） and radiofrequency ablation （RFA） for multiple HCC within the Milan criteria.Methods Clinical data about 140 patients with well-preserved liver function and multinodular HCC within the Milan criteria who received surgical resection （n=78） or RFA （n=62） as initial treatment were retrospectively analyzed. The postoperative complications, liver function and survival data were analyzed and compared.ResultsThe incidences of seroperitoneum, anemia and hypoproteinemia were significantly higher in SR group than RFA group; The levels of postoperative ALT and AST were higher in SR group on the third day after surgery than RFA group; the 1-, 2-, 3-year overall survival rates were 80.8%, 60.3%, 48.7% respectively in SR group and 83.9%, 48.0%, 30.6% respectively in RFA group （P=0.037）; the 1-, 2-, 3-year recurrence-free survival rates were 74.4%, 47.4%, 37.2% respectively in SR group and 71.0%, 38.7%, 21.0% respectively in RFA group （P=0.007）.ConclusionFor patients with multiple HCC and Child-pugh A liver function, surgical resection may still be an optimal choice when tumors within Milan criteria.

关 键 词：肝细胞癌 多发 米兰标准 射频消融 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]