原发性小肝癌射频消融与无水乙醇注射治疗对比研究

目的探讨射频消融(RFA)和经皮穿刺无水乙醇注射治疗(PEIT)治疗原发性小细胞肝癌(SHCC)患者的最佳适应证。方法对127例SHCC进行了RFA和PEIT,其中RFA组81例共97个病灶,PEIT组46例共59个病灶。比较患者RFA及PEIT 1、2、3、4、5年生存率和并发症,统计两组患者的医疗费用。结果两组患者术后均无严重并发症;RFA组术后1、2、3、4、5年生存率分别为91.3%、76.4%、62.8%、51.7%和44.4%;PEIT组病患者术后1、2、3、4、5年生存率分别为78.0%、60.0%、47.8%、37.5%和33.3%;RFA组患者平均治疗费用明显高于PEIT组。结论对于SHCC,RFA疗效优于PEIT;对于位于肝包膜下、大血管分支旁、血供丰富的SHCC,以PEIT为宜;PEIT费用低廉,患者依从性较好。

Comparative study on treatment of small hepatocellular carcinoma by radiofrequency ablation and percutaneous ethanol injection

Objective To investigate the best adaptation of radiofrequency ablation(RFA) and percutaneous ethanol injection(PEI) in the treatment of small hepatocellular carcinoma(SHCC).Methods One hundred and twenty-seven patients with 156 lesions were treated by RFA or PEI.Eighty-one patients with 97 nodules were in RFA group,and fourty-six patients with 59 nodules were in PEI treatment(PEIT) group.The complications,cost for treatments,and survival rate of 1,2,3,4,5-year were compared.Results No severe complications were observed in all patients.Survival rate of 1,2,3,4,5-year was 91.3%,76.4%,62.8%,51.7%,44.4% in RFA group and 75.7%,60.0%,47.8%,37.5%,33.3% in PEIT group,respectively.The cost of treatment was lower in PEIT group than in RFA group.Conclusion Therapeutic effect of RFA on SHCC is better,but the cost of PEIT is cheaper.For subcapsular tumors or lesions near the vessel,PEIT maybe the better choice for treatment.