微波天线组合对不同大小肝癌热凝灭活的作用

目的]探讨微波（2450MHz）天线多种组合方式经皮穿刺热凝方法及对肝癌的最佳灭活范围。方法]200例患者299个肿瘤按大小分A、B、C、D4组，每组50例。A组：肿瘤直径≤2cm采用单支天线热凝方法。B组：2cm〈肿瘤直径3cm采用双天线组合方法。C组：3cm〈肿瘤直径≤4cm，采用三支天线组合方法。D组：4cm〈肿瘤直径≤5cm，采用四支天线组合方法。术后35±5d、2个月、4个月和6个月分别行MRI或CT增强扫描检查，随访近、远期肿瘤灭活效果。结果]A组4次复查未见原位复发，热凝灭活率为100％；B组35±5d、2个月未见复发，4个月出现2例原位复发，热凝灭活率为96％（48／50）；C组首次复查1例复发，2个月后新增1例，4个月后再增2例，共4例出现原位残灶复发，热凝灭活率为92％（46／50）；D组为首次复查3例复发，2个月后新增6例，4个月后再增1例，6个月再增1病例，全组共11例出现原位残灶复发，热凝灭活率为78％（39／50）。结论]微波经皮穿刺热凝方法对瘤径2cm≤肿瘤近、远期可达到100％灭活，疗效肯定。随着直径增大，灭活率有所降低，但基本满意。原位一次完全灭活有一定困难，术后复发率较高。

Thermal Coagulation Inactivation of Microwave Antenna Combination for Liver Cancer with Various Tumor Volume

Purpose ] To study percutaneous thermal coagulation method with various combinations of microwave （2450MHz） antenna and the optimal inactivation range to liver cancer. Methods] Two hundred cases with 299 tumor lesions were divided into 4 groups （A,B,C,D） according to tumor sizes with 50 cases in each group. Single-antenna coagulation method was used in group A（tumor diameter ≤2cm）, two-antenna combination in group B（2cm〈tumor diameter≤3cm）, three-antenna combination in group C（3cm〈tumor diameter≤4cm）, and four-antenna combination in group D（4cm〈tumor diameter≤5cm）. The contrast enhanced MRI or CT scanning was performed to investigate the short and long-terca effect of inactivated tumor 35±5 days, 2 months, 4 months and 6 months after treatment respectively. Results] No local recurrence was found in group A with 4 times follow-up, reaching 100% thermal coagulation inactivation rate. In group B, no recurrence was found in 35±5 days＇ and 2 months＇ follow-up, 2 cases with local recurrence in 4 months, with coagulation inactivation rate 96% （48/50）. In group C, recurrence occurred in 1 case in the first follow-up, 1 cases in 2 months, 2 cases in 4 months, with total 4 cases recurrence, thermal coagulation inactivation rate 92% （46/50）. In group D, there were total 11 cases recurrence, with 3 cases in the first follow-up, 6 cases in 2 months, 1 case in 4 months, 1 case in 6 months, respectivesly, with thermal coagulation inactivation rate 78% （39/50）. Conclusion] Percutaneous microwave thermal coagulation for tumor could reach a 100% recent short-and long-term inactivation with the tumor diameter ≤2cm. Inactivation rate is decreasing with the increasing of tumor diameter. It is hard to get complete local inactivation which results in a higher recurrence rate.