经动脉化疗栓塞联合微波消融治疗多结节肝细胞癌的短期疗效分析  

A short-term outcome analysis of transarterial chemoembolization combined with microwave ablation for multinodular hepatocellular carcinoma

作　　者：李群[1] 王燕[2] 周文辉 李学达[1] 杨莉莉[1] 李子祥[1] LI Qun;WANG Yan;ZHOU Wenhui;LI Xueda;YANG Lili;LI Zixiang(Department of Interuentiojml Medical Center,the Affiliated Hospital of Qingdao University ,Qingdao,266000 ,China;De partmerit of General Medicine , the Affiliated Hospital of Qingdao University ,Qingdao 266000 ,China)

机构地区：[1]青岛大学附属医院介人医学中心,山东青岛266000 [2]青岛大学附属医院全科医学科,山东青岛266000

出　　处：《实用放射学杂志》2019年第4期626-629,共4页Journal of Practical Radiology

摘　　要：目的评估和比较传统经动脉化疗栓塞(TACE)与微波消融(MWA)联合TACE治疗多结节肝细胞癌(HCC)的短期疗效。方法2015年1月至2017年1月收治的多结节HCC患者58例,Child-Pugh分级为A、B级,其中34例(A组)行TACE治疗,24例(B组)行TACE联合MWA治疗。通过随访分析2组患者的肿瘤进展时间(TTP),局部复发率,新发病灶率以及术后并发症的发生情况,评估其短期疗效。结果2组患者术后并发症发生率分别为2.9%(1/34)和4.2%(1/24),TTP分别为38.240(106.2±63.1)d和90-630(328.5士17&8)d,其中A组局部复发率52.9%(18/34),新发病灶率76%(26/34);B组局部复发率为8.3%(2/24).新发病灶率66.7%(16/24)。2组局部复发率差异有统计学意义(P<0.05),新发病灶率差异无统计学意义(P>0.05).结论TACE联合MWA治疗多结节HCC的治疗方法安全有效,相比传统TACE治疗可以显著提高患者的TTP和局部控制率。Objective To investigate the short-term efficacy of transcatheter arterial chemoembolization (TACE) combined with microwave ablation ( MWA;TACE-MWA) in the treatment of multinodular hepatocellular carcinoma ( HCC). Methods 58 patients with multinodular HCC treated in the interventional medicine center from January 2015 to January 2017 were included in grade A or B.34 cases (group A) received TACE and 24 cases (group B) underwent TACE-MWA therapy.The short-term efficacy was evaluated by followup and an alysis of the time to progressi on (TTP), local recurrence rate, new lesion rate, and postoperative complications in b oth groups. Kesults The TTP in the two groups was 38 - 240 ( 106.2zE63.1) days and 90 - 630 (328.5i 17&8) days respectively.The incidence of postoperative complications in two groups was 2.9%(1/34) and 4.2%(1/24) respectively.In group A, the local recurrence rate was 52.9%(18/34) and the new focus rate was 76%(26/34);in the group B,the local recurrence rate was &3%(2/24) and the new focus rate was 66.7%(16/24).The difference of local recurrenee rate between the two groups was statistically significant (PV0.05), while the incidence of new lesion was not significantly different ( P> 0.05 ). Conclusion TACE-MWA is safe and effective in the treatment of multinodular HCC. Comparing with traditional TACE treatment,TACE-MWA can significantly improved TTP and local control rate.

关 键 词：肝细胞癌 多结节肝癌 微波消融 肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]