超声引导经皮穿刺微波消融联合无水酒精对3~5 cm原发性肝癌的疗效及复发影响因素  

Efficacy and recurrence factors of ultrasound-guided percutaneous microwave ablation combined with anhydrous alcohol injection for 3~5 cm primary liver cancer

作　　者：王宪 吕海茹 Wang Xian;Lyu Hairu(Department of Gastroenterology Imaging and Diagnosis,The third Affiliated Hospital of Air Force Medical University,Xi′an 710032,China;不详)

机构地区：[1]空军军医大学第三附属医院影像诊断科,西安710032 [2]空军军医大学第一附属医院西京医院消化内科超声介入诊疗中心

出　　处：《山西医药杂志》2023年第4期260-264,共5页Shanxi Medical Journal

摘　　要：目的研究了超声引导经皮穿刺微波消融(MWA)联合经皮无水酒精注射(PEI)对3~5 cm原发性肝癌(PLC)的疗效及复发影响因素。方法回顾性分析2018年1月至2021年1月西京医院消化内科收治的PLC患者192例,根据治疗方法的不同分为MWA组和联合组。MWA组患者行超声引导经皮穿刺MWA治疗,联合组在MWA组的基础上使用PEI。比较MWA组和联合组的完全消融(CA)率、安全性、无复发生存期。使用二元Logistic回归分析影响PLC患者治疗后复发的危险因素。结果联合组CA率(92.3%)高于MWA组(80.7%),差异具有统计学意义(P<0.05)。随访过程中,MWA组复发率58.8%,联合组复发率39.7%。MWA组的无复发生存期[(21.6±1.5)个月]明显低于联合组[(25.2±2.5)个月],差异具有统计学意义(P<0.05)。复发组和对照组的AFP水平、HbsAg阳性、MWA联合PEI治疗、肝硬化发生率比较,差异均具有统计学意义(P<0.05)。甲胎蛋白(AFP)、乙型肝炎表面抗原(HbsAg)阳性、肝硬化均为PLC患者治疗后复发的危险因素,MWA联合PEI为PLC患者治疗后复发的保护性因素(P<0.05)。结论与MWA相比,超声引导经皮穿刺MWA联合PEI治疗3~5 cm PLC患者的效果确切,可明显降低无复发生存期和治疗后复发风险,值得推广。Objective To investigate the efficacy and recurrence factors of ultrasound-guided percutaneous microwave ablation(MWA)combined with anhydrous alcohol injection(PEI)for 3-5 cm primary liver cancer(PLC).Methods A retrospective analysis of 192 PLC patients admitted to the Department of Gastroenterology of Xijing Hospital from January 2018 to January 2021 were performed,and all the patients were divided into MWA group and combined group according to different treatment methods.The patients in the MWA group were treated with ultrasound-guided percutaneous MWA,and the combined group was treated with PEI on the basis of the MWA group.The complete ablation(CA)rate,safety,and recurrence-free survival of the MWA group and the combined group were compared.Binary logistic regression was used to analyze the risk factors affecting the recurrence of PLC patients after treatment.Results The CA rate in the combined group(93.2%)was higher than that in the MWA group(80.7%),and the difference was statistically significant(P<0.05).During the follow-up,the recurrence rate of the MWA group was 58.8%,and the recurrence rate of the combined group was 39.7%.The recurrence-free survival of the MWA group[(21.6±1.54)months]was significantly lower than that of the combined group[(25.2±2.5)months],and the difference was statistically significant(P<0.05).There were significant differences in alpha-fetoprotein(AFP)level,HbsAg positive,MWA combined with PEI treatment,and incidence of liver cirrhosis between the recurrence group and the control group(P<0.05).AFP,HbsAg positive,and liver cirrhosis were all risk factors for the recurrence of PLC patients after treatment,and MWA combined with PEI was a protective factor for the recurrence of PLC patients after treatment(P<0.05).Conclusion Compared with MWA,ultrasound-guided percutaneous puncture MWA combined with PEI in the treatment of 3~5 cm PLC patients is effective,and can significantly reduce recurrence-free survival and recurrence risk after treatment,which is worthy of promotion.

关 键 词：消融技术 乙醇 超声外科手术 肝肿瘤 复发 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]