超声引导经皮微波消融治疗邻近血管的原发性肝癌的长期疗效  

Long-term Response of Ultrasound-guided Percutaneous Microwave Ablation for Hepatocellular Carcinoma Adjacent to Vessels

作　　者：杨晓环[1] 黄十佳 于杰[1] 梁萍[1] 于晓玲[1] 程志刚[1] 韩治宇[1] 

机构地区：[1]中国人民解放军总医院,北京100853

出　　处：《肿瘤学杂志》2016年第1期24-28,共5页Journal of Chinese Oncology

基　　金："十二五"国家科技支撑计划(2013BAI01B01)

摘　　要：[目的]探讨超声引导经皮微波消融治疗邻近血管的原发性肝癌的有效性与安全性。[方法]回顾分析536例原发性肝癌患者，共计697个病灶，进行超声引导下微波消融治疗，其中邻近血管组（V组，病灶距离血管5mm以内）189例患者共216个病灶，对照组（C组，病灶位于肝实质安全部位）347例患者共481个病灶。在消融治疗过程中，对消融组织边界的温度进行实时监控。[结果]V组中位随访时间为25．4（3．2～92．2）个月，C组中位随访时间为27．6（2．5～99．31个月。V组216个病灶中207个（96．2％）完全消融，而C组481个病灶中465个（96．8％）完全消融，两组差异无统计学意义（P=0．923）。两组1年、3年、5年局部肿瘤进展率和累计生存率差异也无统计学意义。两组均未发现血管、胆管损伤等严重并发症。[结论]通过严格的温度监控，超声引导经皮微波消融是治疗邻近血管的肝细胞癌的一种有效而安全的技术手段。[Purpose ] To investigate the effectiveness and safety of uhrasound（US）-guided percu- taneous microwave ablation （MWA） in the treatment of hepatocellular carcinoma （HCC） adjacent to vessels. [Methods] US-guided percutaneous MWA was applied to 536 patients with 697 HCC nodules （vessels group：Group V, 189 patients with 216 lesions;control group： Group C,347 pa- tients with 481 lesions. During the ablation,the temperature of marginal ablation tissues was monitored and controlled. [Resuks] The median follow-up was 25.4 months （range 3.2～92.2 months） in Group V, and 25.7 months（range 2.5～99.3 months） in Group C. Technical effectiveness was achieved in 207 of 216 （96.2%） tumors in Group V and 465 of 481 （96.8%） tumors in Group C ,without significant difference between them （P=0.923）. The 1-,3- and 5-year local tumor pro- gression rates and the 1-,3- and 5-year accumulative survival rates in the two groups had no sig- nificant difference. In addition, no serious complications such as vessels or bile ducts injury were found in both of the two groups. [ Conclusion ] With strict temperature monitoring, US-guided per- cutaneous MWA is an efficient and safe technology for treating hepatocellular carcinoma adjacent to vessels.

关 键 词：肝细胞癌 微波消融 血管 超声 经皮酒精注射 

分 类 号：R735.7[医药卫生—肿瘤]