经皮射频毁损治疗原发性肝癌

目的 评价射频毁损（RFA）治疗原发性肝癌（HCC）的近期疗效、安全性及并发症。方法 采用RF－2000型射频治疗仪，在B超引导下经皮治疗78例HCC患者。结果 78例患者（肝功能Child分级：A级58例，B级14例，C级6例）的110个肿块（平均直经6.1cm，1.9-13.7cm）共进行了105次治疗，平均治疗1．3次和6．3个点，平均随访9．2个月（1－16个月）。患者术后肝功能轻度损害，2周左右恢复正常。最常见的不良反应为低热。6例（7．7％）出现并发症，未发生与RFA治疗直接相关的死亡。43例（55．1％）复发，平均发生在治疗后6．1个月。多因素相关分析显示，原位复发与肿块直径呈显著正相关（P＝0．0001）。无原位复发者其治疗点数与肿块直径存在线性关系（r=0.77216,P=0.0001)，回归方程式为y=-1.794 1.733x。结论 RFA是一种治疗HCC安全有效的非手术方法。

Percutaneous radiofrequency ablation treatment of hepatocellular cancer

OBJECTIVE: To evaluate the safety, efficacy and complication of radiofrequency ablation (RFA) in treatment of hepatocellular cancer (HCC). METHODS: 78 HCC patients (58 of Child class A, 14 of Child class B, 6 Child class C) with 110 tumors (with the median diameter of 6.1 cm +/- 2.9 cm and the range of 1.9 to 13.7 cm) were treated by electrodes inserted to the foci percutaneously under ultrasound guidance using RF 2000 generator for 105 times in total (on average for 1.3 times and with 6.3 ablated sessions per patient). After the treatment the patients were followed up for 9.2 months on average (1-16 months). RESULTS: The serum ALT and TBIL were transiently elevated one day after RFA in all patients, and returned to baseline values in 2 weeks. The common response after RFA was mild fever. 6 patients (7.7%) had complications; however, no treatment-related death took place. 43 patients (55.1%) had tumor recurrence 6.1 months after RFA on average. Multivariate analysis demonstrated that the tumor diameter were related significantly to local recurrence (P = 0.0001). There was a significant linear correlation between the number of overlapping ablation sessions and tumor diameter (r = 0.772 16, P = 0.0001) among patients without local recurrence. From further liner regression analysis, a mathematical model: y = -1.794 + 1.733x (P = 0.0001, R-square = 0.5303, y: ablation sessions, x: tumor diameter) was got. CONCLUSION: RFA is a safe and effective nonoperative treatment for HCC.