中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
12期
910-914
,共5页
丁雪梅%杨尹默%柯山%麻增林%李洁%高君%李明颖%曹保信%王劭宏%王剑峰%孙文兵
丁雪梅%楊尹默%柯山%痳增林%李潔%高君%李明穎%曹保信%王劭宏%王劍峰%孫文兵
정설매%양윤묵%가산%마증림%리길%고군%리명영%조보신%왕소굉%왕검봉%손문병
癌,肝细胞%肝裸区%射频消融%疗效%安全性
癌,肝細胞%肝裸區%射頻消融%療效%安全性
암,간세포%간라구%사빈소융%료효%안전성
Carcinoma,hepatocellular%Liver bare area%Radiofrequency ablation%Therapeutic efficacy%Safety
目的 探讨CT引导下经皮射频消融(percutaneous radiofrequency ablation,PRFA)治疗肝裸区肝细胞癌(hepatocellular carcinoma in the bare area,HCCBA)的疗效和安全性.方法 回顾性总结作者在2000年4月至2009年6月间收治的肝细胞癌(hepatocellular carcinoma,HCC)病人的临床资料,共有26例早期HCCBA病人接受了CT引导下PRFA治疗,作为HCCBA组;在右肝非裸区HCC病人中,以癌灶距肝包膜、胆囊和第一肝门主要分支的距离≥1.0 cm为条件,纳入26例作为对照组.两组病人的年龄、性别、基础肝病原因、肝功能分级、癌灶直径等方面的差异无统计学差异(P>0.05).癌灶残留采用PRFA后1个月增强CT和(或)甲胎蛋白(alpha-fetoprotein,AFP)追踪判定,将完全消融至局部肿瘤复发的间隔时间作为无瘤生存时间.用t检验比较癌灶直径,用MannWhitney U检验比较年龄、肝病原因、肝功能分级、AFP水平和穿刺次数等指标,用χ2检验比较完全消融率和局部无瘤生存率等指标.结果 两组术后并发症、穿刺次数和完全消融率无统计学差异(P>0.05).HCCBA组1年、3年和5年局部无瘤生存率分别为88.5%、46.2%和19.2%,对照组分别为92.3%、53.8%和15.4%,两组间亦无统计学差异(P>0.05).结论 CT引导下PRFA治疗HCCBA是安全和有效的,可以作为治疗方案之一.
目的 探討CT引導下經皮射頻消融(percutaneous radiofrequency ablation,PRFA)治療肝裸區肝細胞癌(hepatocellular carcinoma in the bare area,HCCBA)的療效和安全性.方法 迴顧性總結作者在2000年4月至2009年6月間收治的肝細胞癌(hepatocellular carcinoma,HCC)病人的臨床資料,共有26例早期HCCBA病人接受瞭CT引導下PRFA治療,作為HCCBA組;在右肝非裸區HCC病人中,以癌竈距肝包膜、膽囊和第一肝門主要分支的距離≥1.0 cm為條件,納入26例作為對照組.兩組病人的年齡、性彆、基礎肝病原因、肝功能分級、癌竈直徑等方麵的差異無統計學差異(P>0.05).癌竈殘留採用PRFA後1箇月增彊CT和(或)甲胎蛋白(alpha-fetoprotein,AFP)追蹤判定,將完全消融至跼部腫瘤複髮的間隔時間作為無瘤生存時間.用t檢驗比較癌竈直徑,用MannWhitney U檢驗比較年齡、肝病原因、肝功能分級、AFP水平和穿刺次數等指標,用χ2檢驗比較完全消融率和跼部無瘤生存率等指標.結果 兩組術後併髮癥、穿刺次數和完全消融率無統計學差異(P>0.05).HCCBA組1年、3年和5年跼部無瘤生存率分彆為88.5%、46.2%和19.2%,對照組分彆為92.3%、53.8%和15.4%,兩組間亦無統計學差異(P>0.05).結論 CT引導下PRFA治療HCCBA是安全和有效的,可以作為治療方案之一.
목적 탐토CT인도하경피사빈소융(percutaneous radiofrequency ablation,PRFA)치료간라구간세포암(hepatocellular carcinoma in the bare area,HCCBA)적료효화안전성.방법 회고성총결작자재2000년4월지2009년6월간수치적간세포암(hepatocellular carcinoma,HCC)병인적림상자료,공유26례조기HCCBA병인접수료CT인도하PRFA치료,작위HCCBA조;재우간비라구HCC병인중,이암조거간포막、담낭화제일간문주요분지적거리≥1.0 cm위조건,납입26례작위대조조.량조병인적년령、성별、기출간병원인、간공능분급、암조직경등방면적차이무통계학차이(P>0.05).암조잔류채용PRFA후1개월증강CT화(혹)갑태단백(alpha-fetoprotein,AFP)추종판정,장완전소융지국부종류복발적간격시간작위무류생존시간.용t검험비교암조직경,용MannWhitney U검험비교년령、간병원인、간공능분급、AFP수평화천자차수등지표,용χ2검험비교완전소융솔화국부무류생존솔등지표.결과 량조술후병발증、천자차수화완전소융솔무통계학차이(P>0.05).HCCBA조1년、3년화5년국부무류생존솔분별위88.5%、46.2%화19.2%,대조조분별위92.3%、53.8%화15.4%,량조간역무통계학차이(P>0.05).결론 CT인도하PRFA치료HCCBA시안전화유효적,가이작위치료방안지일.
Objective To assess the therapeutic efficacy and safety of CT-guided percutaneous radiofrequency ablation(PRFA) for hepatocellular carcinoma in the bare area (HCCBA). Methods During the period from April 2000 to June 2009, 26 patients with HCCBA were treated with CTguided PRFA, and 26 other HCC patients were selected as controls, whose lesions were located in the right lobe ≥1.0 cm away from the liver capsule, gallbladder, and main portal branches. One month after PRFA, the residual tumors of each patient were examined by contrast-enhanced CT and alpha-fetoprotein test, and repeated PRFA was undertaken if residual was present. Tumor-free survival was defined as the duration from complete ablation to diagnosed local recurrence. The 2-independent-samples t-test was used to compare tumor diameter between HCCBA patients and controls. The MannWhitney U test was used to compare patient's age, etiologies of liver disease, liver function status,number of needle punctures and the value of AFP. A χ2 test was used for comparison of the complete tumor ablation rate and the cumulative local tumor-free survival rate. Results No significant difference was observed in the incidence of complication between the HCCBA patients and the controls (26. 9% vs 19.2%,P＞0.05). There were no differences between the two groups in the number of needle punctures and the complete tumor ablation rate at first PRFA. Furthermore, no differences were observed in the cumulative 1-,3- and 5-year local tumor-free survival rates between HCCBA patients (88. 5%, 46.2% and 19. 2% respectively) and patients in the control group (92.3%, 53.8% and 15.4% respectively). Conclusion CT-guided PRFA is effective and safe for HCCBA and could be preferred as one therapeutic option for HCCBA.
