摘要
目的评估CT引导下低功率微波消融(MWA)联合经TACE治疗特殊解剖部位肝癌患者的疗效、安全性与生存率。方法选取76例HCC患者,应用TACE治疗后分为两组:研究组38例,共42个病灶(距肝被膜、胆囊或大血管<5 mm),行低功率MWA(40 W);对照组38例共46个病灶(距肝被膜、胆囊或大血管≥5 mm),行常规功率MWA(50~70 W),比较两组术后肝功能、甲胎蛋白(AFP)、不良反应及并发症、术后3个月影像学表现以及1年生存率情况。结果研究组中,患者的3处癌灶邻近胆囊,14处邻近大血管,25处邻近肝被膜,所有病灶均完全消融,且无严重并发症出现;研究组术后3个月局部复发率7.1%,对照组8.7%,差异无统计学意义(P=0.788);研究组术后AFP平均下降为(261.23±201.35)ng/mL,对照组平均下降为(278.49±189.14)ng/mL,差异无统计学意义(P=0.155);两组ALT、AST及TBIL术后显著升高,差异无统计学意义(P>0.05);研究组并发症4例(10.5%),对照组并发症3例(7.8%),差异无统计学意义(P=0.692)。两组术后均未出现与治疗相关的死亡病例,1年生存率差异无统计学意义(P=0.556)。结论低功率MWA联合TACE治疗特殊解剖部位的HCC与安全部位同样有效和安全。
Objective To evaluate the curative effect,safety and survival rate of CT-guided low-power microwave ablation(MWA)combined with transcatheter arterial chemoembolization(TACE)in treating patients with hepatocellular carcinoma(HCC)located at special anatomic sites.Methods A total of 76 HCC patients were selected.After receiving TACE,the patients were divided into study group(n=38,42 lesions in total)and control group(n=38,46 lesions in total).In the study group,the distance of lesion from liver capsule,gallbladder or large vessel was less than 5 mm,and CT-guided low-power MWA(40 W)was carried out for all patients.In the control group,the distance of lesion from liver capsule,gallbladder or large vessel was larger than 5 mm,and CT-guided routine-power MWA(50-70 W)was performed for all patients.Postoperative liver function,AFP,adverse reactions and complications,postoperative 3-month imaging findings and one-year survival rate were compared between the two groups.Results In the study group,3 lesions were located adjacent to the gallbladder,14 lesions adjacent to the large vessels,and 25 lesions adjacent to the liver capsule.After MWA,all lesions were completely ablated and no serious complications occurred.The postoperative 3-month local recurrence rates in the study group and control group were 7.1%and 8.7%respectively,the difference was not statistically significant(P=0.788).The postoperative mean reduction of AFP level in the study group and control group was(261.23±201.35)ng/mL and(278.49±189.14)ng/mL respectively,the difference was not statistically significant(P=0.155).Obvious postoperative elevation of ALT,AST and TBIL levels was observed in both groups,but the differences between the two groups were not statistically significant(P>0.05).Complications occurred in 4 patients of the study group(10.5%)and in 3 patients of the control group(7.8%),the difference was not statistically significant(P=0.692).After MWA,no treatment-related death occurred in both groups.No statistically significant difference in one-yea
作者
侯训博
刘瑞宝
尹立楠
许茜楠
HOU Xunbo;LIU Ruibao;YIN Linan;XU Qiannan(Department of Interventional Radiology,Cancer Hospital of Harbin Medical University,Harbin,Heilongjiang Province 150081,China)
出处
《介入放射学杂志》
CSCD
北大核心
2020年第11期1105-1109,共5页
Journal of Interventional Radiology
关键词
肝细胞癌
低功率微波消融
困难解剖部位
TACE
hepatocellular carcinoma
low-power microwave ablation
difficulty-making anatomical site
transcatheter arterial chemoembolization
