摘要
目的评估超声引导下肝恶性肿瘤射频消融治疗的效果和影响因素。方法以2012年3月至2014年3月来我院行RFA治疗的肝恶性肿瘤患者360例为研究对象，对患者的临床资料和术后至少3个月随访影像学检查资料进行回顾性分析，同时分析患者RFA后病灶完全消融率、残留率、复发率和进展率，探讨肝恶性肿瘤RFA治疗效果的影响因素。结果360例患者行肝RFA治疗的次数总共为392次，消融病灶数为412个，病灶直径为（2．51±1．10）cm。术后3个月肿瘤完全消融率为86．11％（310／360），复发率为7．78％（28／360），进展率为6．11％（22／360）。肿瘤残留率受肿瘤位置（位于大血管旁）、病灶大小（≥3cm）和病灶数目（≥3个）的影响（x^2值分别为4．431，10．889，8．000；P值均〈0．05）。肿瘤复发率和进展率受病灶数目（≥3个）影响（x^2值分别为29．032，22．092，P〈0．05）。结论RFA术对控制肝脏恶性肿瘤局部进展具有良好的效果，肿瘤的完全消融率受位于大血管旁、病灶的大小和数目的影响，肿瘤的复发率和进展率受病灶数目的影响。
Objective To evaluate the efficiency and influencing factors of ultrasound-guided percutaneous radiofrequency ablation （RFA） as treatment of hepatic malignant armors. Methods Clinical data and follow-up radiographic images of patients with hepatic malignant tumors who had undergone treatment with ultrasound-guided percutaneous RFA at our hospital between March 2012 and March 2014 were reviewed. Rates of incomplete ablation, recurrence, and tumor progression were calculated, and the factors affecting each were analyzed. Results Four hundred and twelve lesions were ablated in a total of 392 ultrasound-guided percutaneous RFA procedures applied to 360 patients. The average tumor size was 2.51±1.10 cm. During at least 3 months of follow-up, the complete ablation rate was 86.11% （310/360）, the recurrence rate was 7.78% （28/360）, and the progression rate was 6.1% （22/360）. Tumors with vessel-proximal location, size of ≥ 3 cm and ≥ 3 month presence had significantly higher rates of residual lesions after ablation （x2 = 4.431, 10.889 and 8.000, respectively; p〈0.05）. Tumors with ≥ 3 month presence had significantly higher rates of recurrence and progression （x 2 = 29.032 and 22.092, P 〈 0.05）. Conclusion Ultrasound-guided percutaneous RFA can effectively control local progression of hepatic malignant tumors. Tumor size, length of presence, and vessel- proximal location are influencing factors of complete ablation rate, while length of presence is also an influencing factor for the recurrence and progression rates.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2016年第1期69-73,共5页
Chinese Journal of Hepatology
关键词
肝肿瘤
导管消融术
回顾性分析
影响因素
Carcinoma, hepatocellular
Ascites
Tumor marker
Phosphorylated Y-box bindingprotein 1
