射频消融在肝细胞肝癌根治性治疗中的临床价值

目的探索射频消融术（RFA）在肝细胞肝癌（简称肝癌）根治性治疗中的临床应用价值。方法检索近年来有关RFA在肝癌治疗中应用的文献并进行综述。结果肝脏移植、肝切除术和RFA是目前被认为具有治愈性治疗效果的3种方法，其中RFA由于具有较好的局部肿瘤控制效果，近年来较多地用于肝脏移植术前的减瘤治疗，在延长患者的等待期的同时不增加病例脱落及死亡的危险。虽然RFA与肝脏切除术对小肝癌的疗效目前尚有争论，但是RFA联合肝脏切除术，扩大了肝癌患者的手术指征，提高了疗效。结论由于RFA技术良好的局部肿瘤控制能力和微创特点，使其在肝癌的各种治疗策略中发挥越来越重要的作用，并与肝移植及肝部分切除术的优点相互补充，使更多的肝癌患者受益。无论是哪一种治疗方法，术中最大程度地减少残癌的发生率，术后密切随访，复发后积极地治疗才是提高疗效的根本。

Value of Radiofrequency Ablation in Radical Cure for Hepatocellular Carcinoma

Objective To explore the value ofradiofrequency ablation （RFA） in the radical cure for hepatocellular carcinoma （HCC）. Method The recent literatures about RFA in the treatment for HCC were retrieved and reviewed. Results The liver transplantation, liver resection, and RFA were the three effective treatments in curative intent for early HCC. RFA was more frequently used in downsize therapy prior to liver transplantation in recent years because of its excellent local tumor control. Preoperative RFA extended the average waiting time without increasing the risk of dropout. Even though the controversy about effectiveness of RFA and hepatectomy was not been settled, the liver resection com- bined with RFA extended the operation indication of HCC and improved the effectiveness. Conclusions RFA plays more and more important roles among the various treatment strategies in HCC. RFA, liver transplantation, and hepatectomy could be complementary to each other in the treatment for HCC and benefit numerous patients. Among these strategies, the key to improve the effectiveness is that minimum reduces residual tumors and suppresses their growth.