高强度聚焦超声治疗肝细胞癌的疗效及其影响因素

目的:观察原发性肝癌(HCC)经高强度聚焦超声(HIFU)治疗后临床效果并探讨其影响因素.方法:通过对2001-04/2002-12经HIFU治疗的104例原发性肝癌患者肿瘤大小,数目,是否转移,HIFU前后AFP,HIFU前肝功能,ChildPugh分级和TNM分期及彩色多普勒超声检查等指标观察HIFU治疗效果.结果:104例原发性肝细胞癌治疗后HCC患者临床症状缓解率为83.2%(80/104),肝功能好转者占82.7%(86/104),AFP降低超过原数值50%者占62.5%(65/104),彩色多普勒超声检查癌灶灰阶明显增加或减弱,癌灶内血液供应减少或消失.HIFU治疗后生存期3-6mo占59.5%,12mo占38.7%,24mo占25.6%.HIFU治疗效果与治疗前AFP,TNM分期,治疗前是否联合TACE治疗,治疗前是否有转移等因素有关.结论:HIFU治疗HCC是有效和可行的,其疗效与治疗前AFP,TNM分期,治疗前是否联合TACE治疗,治疗前是否有转移等因素有关.

Efficacy of high intensity focused ultrasound in treatment of hepatocellular carcinoma and its influential factors

AIM: To observe the efficacy of high intensity focused ultrasound (HIFU) in the treatment of hepatocellular carcinoma (HCC) and investigate the prognostic factors affecting the overall survival. METHODS: A total of 104 patients with HCC were treated with HIFU and the efficacy was evaluated by the following indexes: tumor size, number, metastasis, alpha fetoprotein (AFP) levels before and after HIFU treatment, hepatic function before HIFU treatment, Child Pugh classifications, TNM stages and variations in color Doppler sonography. RESULTS: After HIFU treatment, the remission rates for clinical symptoms and liver functionwere 83.2% (80/104) and 82.7% (86/104), respec- tively, and the patients with AFP decreased by more than 50% covered a percentage of 62.5% (65/104). After HIFU, color Doppler sonogra- phy manifested coagulative necrosis and tumor blood supply reduction or disappearance in the target region. The survival rates of patients were 59.5% (3-6 mo), 38.7% (12 mo) and 25.6% (24 mo). The therapeutic effects of HIFU were correlated with AFP levels, TNM stages and treatment combined with transcatheter arterial chemoembolization and metastasis before treat- ment. CONCLUSION: HIFU is effective and feasible in the treatment of HCC, and its efficacy is associ- ated with the pretherapeutic AFP levels, TNM stages and treatment combined with transcath- eter arterial chemoembolization and metastasis.