超声引导下局部消融治疗危险区域原发性肝癌的效果及安全性分析  

Effectiveness and safety of ultrasound-guided ablation in treatment of primary liver cancer in dangerous areas

作　　者：王婷 王春妍[2] 刘建勇[2] 周永和[3] 陆伟 李嘉[2] 周莉[2] WANG Ting;WANG Chunyan;LIU Jianyong;ZHOU Yonghe;LU Wei;LI Jia;ZHOU Li(Graduate School,Tianjin Medical University,Tianjin 300070,China;Department of Hepatology,Tianjin Second People’s Hospital,Tianjin 300192,China;Department of Ultrasound,Tianjin Second People’s Hospital,Tianjin 300192,China;Liver Cancer Center,Tianjin Medical University Cancer Institute and Hospital,Tianjin 300060,China)

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市第二人民医院肝病科,天津300192 [3]天津市第二人民医院超声科,天津300192 [4]天津医科大学肿瘤医院肝癌中心,天津300060

出　　处：《临床肝胆病杂志》2021年第7期1594-1598,共5页Journal of Clinical Hepatology

基　　金：天津市卫生健康委科技基金项目(2014KZ009);天津市第二人民医院院所级科研基金项目(YS-0012)。

摘　　要：目的探讨超声引导下经皮局部消融术对危险区域肝癌的治疗效果并评估安全性。方法选取2014年1月—2017年9月天津市第二人民医院收治的179例初次行超声引导下消融术治疗的原发性肝癌患者,按肿瘤位置不同分为危险区域组(134例)和非危险区域组(45例),均接受消融治疗。术后对患者肿瘤复发、死亡情况进行随访,无复发或死亡者随访至2019年9月。比较危险区域组和非危险区域组患者消融术后并发症、肿瘤完全缓解情况、肿瘤复发或进展及术后生存情况。符合正态分布的计量资料2组间比较采用两独立样本t检验;非正态分布的计量资料2组间比较采用Mann-Whitney U检验;计数资料2组间比较采用χ^(2)检验。采用Kaplan-Meier法分析肿瘤局部进展率、累积生存率,2组间比较采用log-rank检验。结果2组患者基线水平无差异。危险区域组和非危险区域组术后轻度、重度并发症发生率,术后1个月甲胎蛋白(AFP)下降率、复常率差异均无统计学意义(42.5%vs 51.1%、6.0%vs 2.22%、75.0%vs 80.0%和33.9%vs 26.3%,P值均>0.05);术后1个月完全缓解率差异无统计学意义(91.8%vs 93.3%,P=0.990);危险区域组和非危险区域组术后1、2年肿瘤无进展生存率分别为60.7%、63.50%和37.1%、55.0%,中位无进展生存时间分别为18个月和27个月,差异无统计学意义(χ^(2)=0.573,P=0.449);术后1、2年累积生存率分别为96.8%、93.3%和90.3%、87.8%,差异无统计学意义(χ^(2)=0.110,P=0.731)。结论超声引导下经皮局部消融术治疗危险区域肝癌可行、安全、有效。Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous local ablation in the treatment of liver cancer in dangerous areas.Methods A total of 179 patients with primary liver cancer who were admitted to Tianjin Second People’s Hospital from January 2014 to September 2017 and underwent ultrasound-guided ablation for the first time were enrolled,and according to tumor location,the patients were divided into dangerous area group with 134 patients and non-dangerous area group with 45 patients.All patients received ablation therapy.The patients were followed up to observe tumor recurrence and death,and the patients without recurrence or death were followed up to September 2019.The two groups were compared in terms of complications after ablation,complete tumor response rate,tumor recurrence or progression,and postoperative survival.The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups;The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the chi-square test was used for comparison of categorical data between two groups;the Kaplan-Meier method was used to analyze local tumor progression rate and cumulative survival rate,and the log-rank test was used for comparison between two groups.Results There were no significant differences in baseline levels between the two groups.There were no significant differences between the dangerous area group and the non-dangerous area group in the incidence rates of mild complications(42.5%vs 51.1%,χ^(2)=1.002,P=0.317)and severe complications(6.0%vs 2.22%,χ^(2)=0.453,P=0.290)and the reduction rate and normalization rate of alpha-fetoprotein within 1 month after ablation(reduction rate:75.0%vs 80.0%,χ^(2)=0.464,P=0.496;normalization rate:33.9%vs 26.3%,χ^(2)=0.381,P=0.537),and there was also no significant difference in complete tumor response rate between the two groups(91.8%vs 93.3%,P=0.990).The dangerous area group had 1-and 2-

关 键 词：癌 肝细胞 导管消融术 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]