瞬时弹性成像技术对射频消融治疗肝细胞癌患者的疗效观察  

Transient elastography for the prediction of efficacy of radiofrequency ablation for hepatocellular carcinoma

作　　者：王佳强[1] 薛红红[1] 白宝艳[1] 李倩 WANG Jia-qiang;XUE Hong-hong;BAI Bao-yan;LI Qian(Department of Ultrasound,Yan’an University Affiliated Hospital,Yan’an 716000,China)

机构地区：[1]陕西省延安大学附属医院超声医学科,延安716000

出　　处：《中国肿瘤临床与康复》2021年第6期644-647,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨瞬时弹性成像技术(TE)对射频消融治疗(RFA)肝硬化后肝细胞癌(HCC患者预后的判断价值。方法选取2018年3月至2019年3月间延安大学附属医院收治的50例肝硬化后HCC患者,均接受RFA治疗,治疗前TE检测,10次检测取中位数,四分位数<30%。治疗后定期随访并评估TE检测对RFA的肝硬化后HCC患者预后的判断价值。结果 50名患者中位年龄61岁,其中72.0%是男性。肝硬化的原因为酒精性肝病(36.0%)、丙型肝炎(6.0%)和乙型肝炎(58.0%)。TE中位值为21kPa(6~52kPa)。半年总生存率、1年总生存率和2年总生存率分别为98.0%、90.0%和78.0%。半年总体复发率、1年总体复发率和2年总体复发率分别为12.0%、28.0%和48.0%。TE值与肿瘤复发无关,差异无统计学意义(P>0.05)。在单变量分析中,TE值、年龄、Child-Pugh B和碱性磷酸酶是总体生存的预测因素,差异均有统计学意义(均P<0.05)。在多变量分析中,TE值、年龄和Child-Pugh B评分是独立的死亡危险因素,差异均有统计学意义(均P<0.05)。与TE值<37kPa(59个月)相比,TE值≥33kPa的患者有较短的生存时间(34个月),差异有统计学意义(P<0.05)。结论瞬时弹性成像技术(TE)可预测RFA的肝硬化HCC患者的总生存率,但不能预测肿瘤复发。Objective To investigate the value of transient elastography( TE) for the prediction of efficacy of radiofrequency ablation( RFA) for hepatocellular carcinoma( HCC). Methods Fifty patients with HCC were enrolled in the study at Yan’an University Affiliated Hospital from March 2018 and March2019. They received RFA and TE was detected before treatment. The median was extracted after 10-time tests and the quartile was < 30%. Patients attended regular follow-up and the value of TE for the prediction of prognosis of HCC was evaluated. Results The median age was 61 years. Among them,72% were male. The cause of cirrhosis included alcoholic liver disease( 36%),hepatitis C( 6%),and hepatitis B( 58%). The median value of TE is 21 k Pa( 6 to 52 k Pa). Half-year,1-year and 2-year overall survival rates were 98. 0%,90. 0%,and 78. 0%,respectively. Half-year,1-year and 2-year overall recurrence rates were 12. 0%,28. 0%,and 48. 0%,respectively. TE value were not associated with tumor recurrence( P>0.05). Univariate analysis showed that TE values,age,Child-Pugh B,and alkaline phosphatase were predictors of overall survival( all P<0.05). In the multivariate analysis,TE values,age and Child-Pugh B score were independent risk factors for death( all P<0.05). Patients with a TE value of ≥ 33 k Pa had a shorter survival( 34 months) than patients with TE value < 37 k Pa( P<0.05). Conclusion Transient elastography can predict overall survival in patients with hepatocellular carcinoma treated with radiofrequency ablation,but it cannot predict tumor recurrence.

关 键 词：瞬时弹性成像 射频消融 肝细胞肿瘤 疗效评估 

分 类 号：R735.7[医药卫生—肿瘤]