摘要
目的:探讨肝细胞癌腹腔镜射频消融(LRFA)治疗前后活检组织端粒酶活性检测对治疗效果评价的价值。方法:2001年8月至2004年10月,34例肝细胞癌合并肝硬化患者在全麻下行LRFA治疗。其中男性27例,女性7例,平均年龄49.9±11.7岁。平均肿瘤直径4.0±1.0cm。肿瘤均位于肝脏表面、肝左外叶或临近胆囊等空腔脏器。LRFA治疗前后,分别对瘤体行腹腔镜超声检查及活检,所得微量组织采用ELISA-TRAP法行端粒酶活性检测及病理学检查。结果:所有病例均顺利完成LRFA治疗。RFA治疗前,病理学诊断阳性率为100%(34/34),端粒酶活性阳性率为91.2%(31/34);RFA治疗后,病理学检查均未发现肿瘤细胞,端粒酶活性阳性率26.5%(9/34)。术后1个月螺旋CT增强扫描提示肿瘤完全坏死率达100%。随访7～40个月(中位21个月),9例RFA治疗后端粒酶表达阳性的患者中,8例射频治疗部位复发;而25例RFA治疗后端粒酶表达阴性的患者中,2例发现肝内新病灶。结论:肝细胞癌合并肝硬化患者LRFA治疗后,活检组织端粒酶活性检测对LRFA治疗效果的评价及预后具有一定的参考价值。
To evaluate the clinical significance of telomerase activity detection in biopsied tissues for evaluating the therapeutic efficacy of laparoscopic radiofrequency ablation （LRFA） for patients with hepatocellular carcinoma （HCC） and liver cirrhosis. Methods： From August 2001 to October 2004, 34 patients with HCC and liver cirrhosis were treated by LRFA under general anesthesi- a, among which 27 were male and 7 female, with a mean age of 49.9±11.7 years. The mean maximum diameter of the tumors was 4.0±1.0cm （median, 4.1cm）. All of the tumors were located on the liver surface, in the lateral segment of the left lobe, or were adjacent to the gallbladder. Laparoscopic ultrasound examination and biopsy of liver nodules were performed before LRFA and immediately after LRFA for telomerase activity detection by ELISA-telomeric repeat amplification protocol （ELlS-TRAP） assay and pathological examination. Results： All patients were treated with LRFA successfully. The positive rates of histopathologic diagnosis .and telomerase activity detection in biopsied tissues were 100% （34/34） and 91.2% （31/34） respectively before LRFA, and 0% and 26.5% respectively after LRFA. The contrastenhanced helical CT scans showed that a complete lesion necrosis was achieved in all patients one month later. During a median follow-up period of 21 months （range, 7-40 months）, 88.9% （8/9） patients with positive telomerase activity after LRFA recurred locally at the ablation sites, and 8% （2/25） pa- tients with negative telomerase activity after LRFA had new malignant nodules within the livers. Conclusion： After LRFA therapy for patients with HCC and liver cirrhosis, detection of telomerase activity in biopsied tissues may be useful for evaluating the therapeutic efficacy of LRFA therapy and predicting postoperative recurrence.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2006年第16期908-911,共4页
Chinese Journal of Clinical Oncology
基金
国家重点基础研究发展规划(973)项目资助(编号:G2000057001)
