B超引导经皮肝穿刺射频治疗肝癌

目的：探讨B超引导经皮肝穿刺射频（PRFA）治疗肝癌的价值。方法：1999年10月－2000年3月对70例肝癌患者进行了B超引导PRFA治疗，并于治疗后每个月进行肿瘤标记物和B超检查，治疗后1个月复查MRI或CT。结果：患者肝功能分级Child A级53例，B级15例，C级2例，原发性肝癌53例，继发性肝癌17例，原发性小肝癌（小于等于5cm，未手术）21例，其中AFP阳性17例，PRFA术后转阴12例，明显降低4例，未降低1例。MRI显示肿癌完全凝固性坏死16例，根治率76．2％，小肝 癌各组PRFA术后3，6个月生存率均为90．5％－100％，大肝癌各组术后3，6个月生存率分别为66．7％－72．7％和27．6％－72．7％，结论：射频作为肿瘤透热治疗的一种方法，对于肝癌尤其是无手术指征，或有手术指征但位于肝中央区，临近腔静脉或肝门区的小肝癌，PRFA具有微创，时间短，安全方便，疗效可靠，对于大肝癌，PRFA可与肝动脉介入化疗栓塞联合应用，以提高疗效。

Percutaneous radiofrequency ablation of hepatic malignancies guided by ultrasonography

Objective　To study the value of B type ultrasonography guiding percutaneous radiofrequency ablation (PRFA) for hepatic cancer (HC). Methods　70 patients with primary or metastatic hepatic malignancies were treated by PRFA under ultrasound guidance through LeVeen multipolar array needle electrode and RF 2000. All patients were followed up by turnor marker, B type sounography and MRI monthly. Results　PRFA were performed in 53 patients with hepatocellular carcinoma (HCC) and 17 cases with metastatic liver cancer. Liver function classfication was 53 cases in Child class A, 15 in class B and 2 in class C. In 21 patients with non-operated small HCC (≤5 cm), 12 of 17 patients with AFP positive were decreased to normal (70.6%) and decreased markedly in 4 (23.5%), and MRI showed the treated tumors were completely necrosis in 16 patients (76.2%). The 3, 6 month survival rates were 90.5%, 100% respectively in small HC groups, and 66.7% to 72.7% and 27.6% to 72.7% in large HC groups.Conclusions　PRFA as a local thermal therapy is becoming a kind of new palliative treatment for hepatic malignancies, which not only is safe, minimally invasive, and effective for small ones; but also can be used with combination of TACE for larger ones.