超声引导下激光与射频消融治疗小肝癌对血清肿瘤标志物的影响及超声造影评价

目的 探讨超声引导下激光与射频消融治疗小肝癌对血清肿瘤标志物的影响及超声造影评价。 方法 选取76例小肝癌患者作为研究对象，分为观察组（超声引导下激光消融治疗）与对照组（超声引导下射频消融治疗），各38例，对比1个月完全消融率，评估治疗前、治疗后4周的甲胎蛋白（lpha-fetoprotein,AFP）、异常凝血酶原Ⅱ(abnormal prothrombin-Ⅱ,PIVKA-Ⅱ)、磷脂酰肌醇蛋白聚糖3（glypican3,CPC3），观察并发症情况（局部疼痛、腹腔出血、胆道出血、胆漏、腹腔感染），以及2年生存率、2年内无进展生存率及生存时间。 结果 观察组的1个月完全消融率高于对照组（P＜0.05）。治疗前，两组AFP、PIVKA-Ⅱ、CPC3比较，差异无统计学意义（P＞0.05）；治疗后，观察组的AFP、PIVKA-Ⅱ、CPC3低于对照组（P＜0.05）。观察组的局部疼痛、腹腔出血、胆道出血发生率低于对照组（P＜0.05）；观察组胆漏及腹腔感染发生率低于对照组，差异无统计学意义（P＞0.05）。观察组2年生存率、2年内无进展生存率及生存时间高于对照组（P＜0.05）。 结论 超声引导下激光与射频消融均是治疗小肝癌的有效方法，但超声引导下激光消融治疗效果更理想，能降低血清肿瘤标志物表达量和提高完全消融率。

The effect of ultrasound-guided laser and radiofrequency ablation on serum tumor markers in the treatment of small liver cancer and the evaluation by contrast-enhanced ultrasound

Objective To explore the effect of ultrasound-guided laser and radiofrequency ablation on serum tumor markers in the treatment of small liver cancer and the evaluation by contrast-enhanced ultrasound.Methods Seventy-six patients with small liver cancer were selected as the research subjects, and divided into the observation group(ultrasound-guided laser ablation treatment, n=38) and the control group(ultrasound-guided radiofrequency ablation therapy, n=38). Complete ablation rate(CAR)at 1 month after treatment was compared, and alpha-fetoprotein(AFP), abnormal prothrombinⅡ(PIVKA-Ⅱ), and glypican 3(CPC3)before treatment and at 4 weeks after treatment were evaluated.The complications(local pain, intraabdominal bleeding, biliary bleeding, bile leakage, abdominal infection), and 2-year survival rate, 2-year progression-free survival(PFS) rate and survival time were observed.Results The 1-month CAR of the observation group was higher than that of the control group(P＜0.05). Before treatment, there was no statistically significant difference between two groups with respect to AFP, PIVKA-Ⅱ, and CPC3(P＞0.05); After treatment, the AFP, PIVKA-Ⅱ, and CPC3 of the observation group were lower than those of the control group(P＜0.05). The incidence of local pain, intraabdominal bleeding, and biliary bleeding in the observation group was lower than that in the control group(P＜0.05). The incidence of bile leakage and abdominal infection in the observation group was lower than that in the control group, but the difference was not statistically significant(P>0.05).The 2-year survival rate, 2-year PFS rate and survival time of the observation group were higher than those of the control group(P＜0.05).Conclusion Ultrasound-guided laser ablation and radiofrequency ablation are both effective methods for the treatment of small liver cancer. However, ultrasound-guided laser ablation is more effective, which can reduce the expression of serum tumor markers and increase CAR.