计算机断层扫描引导下微波消融治疗乙型肝炎相关肝细胞癌肺寡转移瘤的临床应用  

Clinical application of computerized tomography-guided microwave ablation in the treatment of hepatitis B-related hepatocellular carcinoma oligosenterinoma

作　　者：扈彩霞[1] 赵鹏[1] 刘博君[1] 杨晓珍[1] 房达[1] 郑加生[1] 张永宏[1] Hu Caixia;Zhao Peng;Liu Bojun;Yang Xiaozhen;Fang Da;Zheng Jiasheng;Zhang Yonghong(Minimally Invasive Intervention Center for Liver Disease and Tumor,Beijing You'an Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病与肿瘤微创介入中心,北京100069

出　　处：《肝癌电子杂志》2024年第1期1-3,共3页Electronic Journal of Liver Tumor

基　　金：北京市白求恩基金会科研项目(QZHX-21-ZQN-014)。

摘　　要：目的:评估前靶免治疗时代,乙肝相关肝癌合并肺转移瘤患者行微波消融治疗疗效、安全性和应用价值。方法:收集2010年11月至2014年12月在我院诊断为乙肝相关肝癌合并肺转移瘤行微波消融术患者30例,其中男24例,女6例;年龄35~74岁,经胸部CT发现肺部67个转移瘤,共消融67个病灶。肿瘤直径为0.5~4.1cm,平均直径为1.37cm。采用Kaplan-Meier法计算局部肿瘤控制率、中位生存期并观察并发症发生情况。结果:对67个肝癌肺转移瘤成功地进行了46次微波消融治疗。消融后1~3个月,肺部增强CT提示靶病灶区未见强化,肿瘤的完全消融率为100%,中位生存期为27.5个月,主要并发症包括局部疼痛(6例)、阵咳(13例)、少量咳血(3例),有10例患者发生少量气胸,未予特殊处理,有3例患者发生中等量至大量气胸,即刻行胸腔闭式引流。结论:CT引导下微波消融治疗乙肝相关肝癌肺转移瘤,安全有效,是晚期肝癌患者局部治疗的重要手段。Objective:To evaluate the efficacy,safety and application value of microwave ablation for patients with liver cancer associated with hepatitis B and lung metastases in the era of pre-target immunotherapy.Methods:From November 2010 to December 2014,30 patients(24 males and 6 females)with pulmonary metastases were treated by microwave ablation Age ranged from 35 to 74 years,with a median age of 57.1 years.67 pulmonary metastases were detected by chest CT and 67 lesions were ablated.The diameter of the tumor ranged from 0.5 cm to 4.1 cm in 9 patients with single lesion,5 patients with 2 lesions and 16 patients with 3 lesions,the average diameter was 1.37 cm.Kaplan-meier method was used to calculate local tumor control rate,median survival time and complications.Results:Microwave ablation was successfully performed 46 times in 67 cases of liver cancer with lung metastases.One to three months after ablation,enhanced CT showed no enhancement in the target area.The complete ablation rate was 100%,and the median survival time was 27.5 months,the main complications included local pain(6 cases),paroxysmal cough(13 cases)and a small amount of hemoptysis(3 cases),10 patients developed mild pneumothorax without special treatment,and 3 patients developed moderate to severe pneumothorax.Immediate closed chest drainage was performed.Conclusion:CT-guided microwave ablation is a safe and effective method for the treatment of lung metastases from hepatitis B-related liver cancer.

关 键 词：乙型肝炎相关肝细胞癌 肺寡转移瘤 微波消融 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]