摘要
目的比较CT和超声引导经皮射频消融治疗早期肝癌(肿瘤长径<3 cm)的效果。方法回顾性病例系列研究。回顾性分析武汉市东西湖区人民医院2012年3月至2021年10月接受经皮射频消融治疗的50例早期肝癌患者的临床资料,根据消融时影像引导方法分为CT引导组(30例)与超声引导组(20例)。比较两组患者的复发率、治疗结果和不良反应。结果CT引导组男性24例,女性6例,年龄(56±9)岁;超声引导组男性16例,女性4例,年龄(53±11)岁。两组患者的性别、年龄、病毒感染情况、体能状况评分、肿瘤长径、病灶数目、Child-Pugh分级、血清甲胎蛋白水平、手术切除史比较,差异均无统计学意义(均P>0.05)。CT引导组和超声引导组中位随访时间分别为23个月(95%CI:15~31个月)和85个月(95%CI:77~93个月)。CT引导组和超声引导组复发率分别为60.0%(18/30)、80.0%(16/20),差异无统计学意义(χ^(2)=2.21,P=0.220)。两组患者病灶均获得了完全消融,技术成功率为100.0%(50/50)。CT引导组1、3、5、7年总生存率分别为93.2%、72.3%、72.3%、72.3%,超声引导组分别为95.0%、70.0%、59.2%、53.3%,两组总生存差异无统计学意义(χ^(2)<0.01,P=0.970)。CT引导组和超声引导组中位无病生存时间分别为15.0个月(95%CI:12.6~17.4个月)和18.0个月(95%CI:6.3~29.7个月),两组无病生存差异无统计学意义(χ^(2)=2.37,P=0.123)。CT引导组与超声引导组不良反应发生率分别为90.0%(27/30)、85.0%(17/20),差异无统计学意义(χ^(2)=0.01,P=0.670)。结论超声和CT引导经皮射频消融治疗早期肝癌的临床效果相似。
ObjectiveTo compare the clinical effectiveness of CT-and ultrasound-guided percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma(the longest tumor diameter≤3 cm).MethodsA retrospective case series study was performed.The clinical data of 50 patients with early-stage hepatocellular carcinoma who received percutaneous radiofrequency ablation in Wuhan Dongxihu District People's Hospital from March 2012 to October 2021 were retrospectively analyzed.All patients were divided into CT-guided group(30 cases)and ultrasound-guided group(20 cases)according to the ablation imaging-guided methods.The recurrence rate,treatment outcome and adverse reactions were compared between the two groups.ResultsIn the CT-guided group,24 cases were male and 6 cases were female;the age was(56±9)years old.In the ultrasound-guided group,16 cases were male and 4 cases were female;the age was(53±11)years old.There were no statistically significant differences in gender,age,virus infection,performance status score,the longest tumor diameter,lesion number,Child-Pugh grade,serum alpha-fetoprotein level,and the history of surgery resection between the two groups(all P>0.05).The median follow-up time in the CT-guided group and the ultrasound-guided group was 23 months(95%CI:15-31 months)and 85 months(95%CI:77-93 months),respectively.The recurrence rate was 60%(18/30)in the CT-guided group and 80%(16/20)in the ultrasound-guided group,and the difference was not statistically significant(χ^(2)=2.21,P=0.220).All patients in both groups acquired complete ablation and the successful rate was 100.0%(50/50).The 1-,3-,5-and 7-year overall survival rates in the CT-guided group were 93.2%,72.3%,72.3%,and 72.3%,respectively,and 95.0%,70.0%,59.2%,and 53.3%,respectively in the ultrasound-guided group;the difference in the overall survival between the two groups was not statistically significant(χ^(2)<0.01,P=0.970).The median disease-free survival time was 15.0 months(95%CI:12.6-17.4 months)in the CT-guided group and 18.0 months(95%CI
作者
章万勇
Zhang Wanyong(Department of Interventional Radiology,Wuhan Dongxihu District People's Hospital,Wuhan 430040,China)
出处
《肿瘤研究与临床》
CAS
2024年第9期687-691,共5页
Cancer Research and Clinic
关键词
癌
肝细胞
射频消蚀
影像引导
体层摄影术
X线计算机
超声检查
治疗结果
Cacinoma,hepatocelluar
Radiofrequency ablation
Image guidance
Tomography,X-ray computed
Ultrosonography
Treatment outcome
