CT引导下经皮无水乙醇注射联合射频消融治疗高危部位原发性肝癌  

CT-guided Percutaneous Ethanol Injection Combined With Radiofrequency Ablation for Treatment of Primary Liver Cancer in High-risk Locations

作　　者：李文东 郭晓笛 陈京龙 丁晓燕 孙巍 孙莎莎 申燕军 李莉 Li Wendong;Guo Xiaodi;Chen Jinglong(Department of Oncology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院肿瘤内科,北京100015

出　　处：《中国微创外科杂志》2021年第7期605-609,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：首都临床特色应用研究(Z181100001718131)。

摘　　要：目的探讨CT引导下经皮无水乙醇注射(percutaneous ethanol injection,PEI)联合射频消融(radiofrequency ablation,RFA)治疗高危部位原发性肝癌的疗效和安全性。方法回顾性分析2017年1月~2018年12月我科收治的58例高危部位原发性肝癌患者的资料,其中PEI联合RFA组28例44个高危病灶,RFA组30例46个高危病灶。PEI联合RFA组中无水乙醇注射于高危部位病灶的高危部分,而RFA覆盖非高危部分。以术后1个月增强CT或增强MRI未见强化为完全消融。结果PEI联合RFA组肿瘤完全消融率[93.2%(41/44)]明显高于RFA组[73.9%(34/46),χ^(2)=6.012,P=0.014]。2组手术相关严重并发症发生率差异无统计学意义[0%(0/28)vs.6.7%(2/30),P=0.492],2组常见不良反应发生率差异亦无统计学意义(P均>0.05)。2组2年肿瘤局部进展率分别为18.2%(8/44)和32.6%(15/46),差异无统计学意义(χ^(2)=2.460,P=0.117)。结论与单纯RFA比较,PEI联合RFA治疗高危部位原发性肝癌可明显提高肿瘤完全消融率,且不增加并发症发生率。Objective To investigate the clinical efficacy and safety of CT-guided percutaneous ethanol injection(PEI)combined with radiofrequency ablation(RFA)for patients with primary liver cancer(PLC)in high-risk locations.Methods From January 2017 to December 2018,58 patients with PLC in high-risk locations were retrospectively analyzed,including 28 patients with 44 high-risk lesions in the PEI combined with RFA group and 30 patients with 46 high-risk lesions in the RFA group.In the PEI combined with RFA group,ethanol was injected into the high-risk part of the lesion while RFA was used to cover the non-high-risk part.No enhancement of the high-risk lesions on contrast-enhanced CT or MRI one month after operation indicated complete ablation.Results The complete ablation rate of the PEI combined with RFA group[93.2%(41/44)]was significantly higher than that of the RFA group[73.9%(34/46);χ^(2)=6.012,P=0.014].There was no significant difference in the incidence of severe complications between the two groups[0%(0/28)vs.6.7%(2/30),P=0.492].No significant differences in the incidence of common adverse events were found between the two groups(all P>0.05).The 2-year local tumor progression rate of the PEI combined with RFA group was similar to the RFA group[18.2%(8/44)and 32.6%(15/46),respectively;χ^(2)=2.460,P=0.117].Conclusion Compared with the RFA,PEI combined with RFA for treatment of PLC in high-risk locations may further improve the complete ablation rate significantly without increasing the incidence of complications.

关 键 词：肝癌 高危部位 射频消融 无水乙醇 

分 类 号：R735.7[医药卫生—肿瘤]