经皮肝穿刺射频热凝治疗肝脏恶性肿瘤

目的 探讨经皮肝穿刺射频热凝治疗肝癌的意义。适应证和疗效评价标准。方法 1999年10月-2000年10月,100例肝脏恶性肿瘤患者进行了B超引导经皮肝穿刺射频热凝治疗。患者治疗后每个月进行血清肿瘤标记物检测、B超检查,治疗后1个月复查MRI。结果 患者肝功能ChildA级67例,ChildB级29例,ChildC级4例,原发性肝癌76例,转移性肝癌24例,小肝癌（未手术,肿瘤直径≤5cm)甲胎蛋白阳性者治疗后甲胎蛋白转阴占75.0%(21/28),明显下降占21.4%(6/28)。B超复查肿瘤缩小、MRI或CT提示≤5cm肿瘤完全凝固性坏死率85.9%(61/71)。结论 经皮肝穿刺射频热凝（PRFA）作为肿瘤透热治疗的一种方法,对于小肝癌尤其是无手术指征,或有手术指征但位于肝中央区,临近腔静脉或肝门区的小肝癌,是一种微创、时间短、安全方便、疗效可靠的新方法,对于大肝癌,PRFA可与肝动脉介入化疗栓塞联合应用,提高疗效。

Percutaneous radiofrequency ablation of liver malignancies

Objective To describe the safety and efficacy of percutaneous radiofrequency ablation (PRFA) to treat liver canc er. Methods One hundred patients with histolog ically or clinically confirmed primary or metastatic malignancies were treated p ercutaneously under ultrasound guidance using LeVeen multipolar array needle ele ctrode and RF 2000 generator between October, 1999 and October, 2000. All patie nts were followed up to assess complication, treatment response, recurrence and curative effect. Results PRFA was performed in 76 patients with primary liver cancer and 24 patients with metastatic liver can cer. AFP positive of small hepatic cancer (inoperative) became AFP negative in 7 50% patient (21/28). The rate of completely concreted necrosis of small hep atic malignancies shown by MRI was 859%(61/71). Conclusion s PRFA as a local thermal therapy is a kind of new palliative t reatment for hepatic malignancies. It is minimally invasive, safe and effecti ve especially for small hepatic tumers and can also be used in conjunction with TACE for larger ones.