超声引导下经皮激光消融与射频消融治疗微小肝细胞癌的疗效对比

目的：通过与超声引导下经皮射频消融（RFA）比较，观察超声引导下经皮激光消融（LA）治疗微小肝细胞癌（HCC）的临床疗效。方法回顾性分析54例微小 HCC 患者的临床资料，按照治疗方法的不同将其分为 LA 组（n ＝27）和 RFA 组（n ＝27）。LA 组患者接受超声引导下 LA 治疗，RFA 组接受超声引导下 RFA 治疗，观察近期疗效及不良反应，随访患者的肿瘤局部控制率和无进展生存期（PFS）。结果LA 组和 RFA 组患者治疗后的总有效率分别为81．48％、77．78％，差异无统计学意义（χ2＝0．11，P ＝0．74）；两组患者1年肿瘤局部控制率分别为77．78％、51．85％，差异有统计学意义（χ2＝14．74，P ＝0．00）；两组患者中位 PFS 分别为（12．52±6．57）个月和（8．67±5．13）个月，差异有统计学意义（χ2＝4．70，P ＝0．03）。LA 组和 RFA 组治疗后出现的不良反应如穿刺区域疼痛（40．74％∶33．33％；χ2＝0．32，P ＝0．57）、腹腔出血（7．41％∶11．11％；P ＝0．64）、胆道出血（0∶3．70％；P ＝0．31）、胆漏（7．41％∶14．81％；P ＝0．39）、腹腔感染（3．70％∶11．11％；P ＝0．30）的差异均无统计学意义。结论与 RFA 比较，LA 可提高微小 HCC 患者的肿瘤局部控制率，并延长患者的 PFS，具有一定的临床应用价值和前景。

Effect comparison between ultrasound guided percutaneous laser ablation and radiofrequency ablation for the treatment of small hepatocellular carcinoma

Objective To compare the effects between ultrasound guided percutaneous laser ablation (LA)and radiofrequency ablation (RFA)for small hepatocellular carcinoma (HHC).Methods We retro-spectively reviewed the data of 54 patients with small HHC.According to the different methods of treatment,54 patients were divided into LA group (n =27)and RFA group (n =27).Patients in LA group were treated with ultrasound guided percutaneous LA,and patients in RFA group were treated with RFA.The adverse reaction and short-term curative effect were observed.The local tumor control rate and progression-free survival (PFS) of patients were follow-up visited.Results After treatment,the total response rates of patients in LA group and RFA group were 81 .48% and 77.78% respectively,with no significant difference (χ2 =0.1 1 ,P =0.74).The 1 -year local tumor control rates of patients in LA group and RFA group were 77.78% and 51 .85%respectively,with a significant difference (χ2 =1 4.74,P =0.00).The median PFS of patients in LA group and RFA group were (1 2.52 ±6.57)months and (8.67 ±5.1 3)months,with a significant difference (χ2 =4.70,P =0.03).The adverse reactions of patients in LA group and RFA group after treatment were puncture region pain (40.74% vs.33.33%;χ2 =0.32,P =0.57),retroperitoneal hemorrhage (7.41 % vs.1 1 .1 1 %;P =0.64),hemobilia (0 vs.3.70%;P =0.31 ),bile leakage (7.41 % vs.1 4.81 %;P =0.39),and ab-dominal infection (3.70% vs.1 1 .1 1 %;P =0.30),with no significant differences.Conclusion Compared with RFA,LA may improve the local tumor control rate and prolong the PFS of patients with small HHC,which has a certain clinical practice value and prospect.