微波消融对直径<5 cm肝癌的治疗效果和患者长期生存的影响因素分析  

Analysis of therapeutic effect and long-term survival factors of patients with hepatocellular carcinoma less than 5 cm in diameter by microwave ablation

作　　者：王忠[1] 刘启榆[1] 杨伟[1] 周西[1] 范丹丹[1] WAGN Zhong;LIU Qi-yu;YANG Wei;ZHOU Xi;FAN Dan-dan(Department of Radiology,Mianyang Central Hospital,Sichuan,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院放射科

出　　处：《中国医学前沿杂志（电子版）》2019年第10期58-61,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：四川省医学会科研课题（Q14034）

摘　　要：目的分析微波消融对直径<5cm肝癌的治疗效果和影响患者长期生存的因素。方法收集2012年10月至2014年4月本院收治的206例接受微波消融治疗的肝癌患者的临床资料,观察患者的治疗效果和随访生存情况,同时分析影响患者长期生存的因素。结果206例肝癌患者的完全消融率为96.12%(198/206),肿瘤残余率3.88%(8/206),微波消融治疗后6、12、18、24、30、36、42、48、54、60个月的总体生存率分别为82.52%、76.70%、66.02%、57.28%、49.03%、39.32%、27.18%、16.50%、10.19%、5.83%;微波消融治疗后6、12、18、24、30、36、42、48、54、60个月,患者的无瘤生存率分别为79.73%、58.11%、40.54%、33.78%、28.38%、16.22%、10.81%、8.11%、4.05%、0。微波消融治疗后60个月,不同肝功能分级、不同复发间隔时间、不同术前甲胎蛋白水平、不同肿瘤直径、不同巴塞罗那分期患者的术后总生存率比较差异均有统计学意义(均P<0.05)。复发间隔时间、术前甲胎蛋白水平、肿瘤直径、巴塞罗那分期均是肝癌患者微波消融治疗后长期生存的影响因素(均P<0.05)。结论微波消融治疗直径<5cm肝癌的完全消融率高,但患者术后长期生存率和无瘤生存率均较低,肿瘤大小、复发间隔时间、术前甲胎蛋白水平、巴塞罗那分期均会影响微波消融治疗后肝癌患者的长期生存。Objective To observe the therapeutic effect and long-term survival factors of patients with hepatocellular carcinoma less than 5 cm in diameter by microwave ablation. Method The clinical data of 206 patients with liver cancer treated with microwave ablation in our hospital from October 2012 to April 2014 were collected. The curative effect and follow-up survival were observed. Factors influencing longterm survival of patients with liver cancer were analyzed. Result The complete ablation rate of 206 patients with liver cancer was 96.12%(198/206), and the tumor residual rate was 3.88%(8/206). The overall survival rates at 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months after microwave ablation were 82.52%, 76.70%, 66.02%, 57.28%, 49.03%, 39.32%, 27.18%, 16.50%, 10.19% and 5.83%, respectively. The tumor-free survival rates of patients at 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 months after microwave ablation were 79.73%, 58.11% 40.54%, 33.78%, 28.38% 16.22%, 10.81%, 8.11% 4.05% and 0, respectively. At 60 months after microwave ablation, there were significant differences in postoperative overall survival rate among patients with different liver function grades, different recurrence intervals, different preoperative alpha-fetoprotein levels, different tumor diameters and different Barcelona stages (all P < 0.05). Recurrence interval, preoperative alpha-fetoprotein level, tumor diameter and Barcelona stages were the influencing factors of long-term survival after microwave ablation (all P < 0.05). Conclusion The complete ablation rate of liver cancer with diameter < 5 cm by microwave ablation is higher, but the long-term survival rate and disease-free survival rate are lower. Tumor size, recurrence interval, preoperative alpha-fetoprotein level and Barcelona stages all affect the long-term survival of patients with liver cancer after microwave ablation.

关 键 词：肝癌 微波消融 长期生存 影响因素 

分 类 号：R735.7[医药卫生—肿瘤]