摘要
目的比较超声引导下射频消融术与微创切除术治疗小肝癌的疗效。方法选取2015年3月—2018年4月海南省中医院接受治疗的80例小肝癌患者,根据自愿原则分为消融组和切除组,每组40例。消融组接受超声引导下射频消融术治疗,切除组接受微创切除术。比较两组肝功能[谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)]、肿瘤标志物[癌胚抗原(CEA)、磷脂酰肌醇蛋白聚糖3(GPC3)、甲胎蛋白(AFP)]、循环肿瘤细胞(CTC)和肝细胞生长因子(HGF)、并发症、术后复发率及生存率。结果两组患者术前ALT、AST、TBIL水平比较,差异无统计学意义(P>0.05)。消融组术后ALT、AST、TBIL水平低于切除组(P<0.05)。两组患者手术前与手术后CEA、GPC3、AFP水平比较,差异无统计学意义(P>0.05)。两组患者术前HGF、CTC水平比较,差异无统计学意义(P>0.05)。消融组术后HGF、CTC水平低于切除组(P<0.05)。消融组术后并发症发生率低于切除组(P<0.05)。两组患者术后3年总生存率、术后3年复发率比较,差异无统计学意义(P<0.05)。结论与微创切除术比较,超声引导下射频消融治疗小肝癌在减少肝功能损伤、术后并发症方面具有一定优势,且可在一定程度上降低HGF和CTC水平,两者具有相似的远期预后效果。
Objective To compare the long-term outcomes of ultrasound-guided radiofrequency ablation and minimally invasive hepatectomy for small hepatocellular carcinoma.Methods A total of 80 patients with small hepatocellular carcinoma who were treated in our hospital from June 2015 to May 2018 were included in the study.The patients underwent either ultrasound-guided radiofrequency ablation(ablation group)or minimally invasive hepatectomy(resection group)as they might wish,with 40 cases in each group.The liver function[alanine aminotransferase(ALT),total bilirubin(TBIL)and aspartate aminotransferase(AST)],tumor markers[carcinoembryonic antigen(CEA),Glycan-3(GPC3)and alpha-fetoprotein(AFP)],circulating tumor cells(CTC),hepatocyte growth factor(HGF),postoperative complications,recurrence rate and survival rate were compared between the two groups.Results There was no difference in preoperative ALT,AST and TBIL levels between the two groups(P>0.05).The postoperative levels of ALT,AST,and TBIL in the ablation group were lower than those in the resection group(t=4.620,2.880 and 2.477;P=0.000,0.005 and 0.015).Both preoperative and postoperative levels of CEA,GPC3,and AFP were not different between the groups(t=0.211,0.149 and 0.518;P=0.833,0.882 and 0.606).The postoperative levels of HGF and CTC in the ablation group were lower than those in the resection group(t=2.549 and 3.014,P=0.013 and 0.003),but with no difference in levels of HGF and CTC before the operations(P>0.05).The overall incidence of postoperative complications in ablation group(5.00%)was significantly lower than that in resection group(20.00%)(χ^(2)=4.114,P=0.043).There was no significant difference in 3-year survival rate and 3-year recurrence rate between the two groups(χ^(2)=0.092 and 0.157,P=0.762 and 0.692).Conclusions Compared with minimally invasive hepatectomy in the treatment of small hepatocellular carcinoma,ultrasound-guided radiofrequency ablation has certain advantages in reducing liver function damage and postoperative complications,and can impro
作者
王超
郑柏
桂茂崇
陈小鹏
江元勋
纪杏怡
Chao Wang;Bo Zheng;Mao-chong Gui;Xiao-peng Chen;Yuan-xun Jiang;Xing-yi Ji(Department of Ultrasound,Hainan Hospital of Traditional Chinese Medicine,Haikou,Hainan 570203,China)
出处
《中国现代医学杂志》
CAS
北大核心
2021年第16期7-11,共5页
China Journal of Modern Medicine
基金
海南省重点研发计划项目(No:ZDYF2019179)。
关键词
肝肿瘤
射频导管消融术
外科手术
微创性
预后
small hepatocellular carcinoma
radiofrequency ablation
minimally invasive surgery
prognosis
