[1]张 利,姚俊芳,张 磊,等.超声引导下经皮微波热消融术治疗中晚期原发性肝细胞肝癌疗效观察[J].新乡医学院学报,2021,38(12):1133-1136.[doi:10.7683/xxyxyxb.2021.12.005]
 ZHANG Li,YAO Junfang,ZHANG Lei,et al.Effect of ultrasound-guided percutaneous microwave ablation in treatment of advanced hepatocellular carcinoma[J].Journal of Xinxiang Medical University,2021,38(12):1133-1136.[doi:10.7683/xxyxyxb.2021.12.005]
点击复制

超声引导下经皮微波热消融术治疗中晚期原发性肝细胞肝癌疗效观察
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年12
页码:
1133-1136
栏目:
临床研究
出版日期:
2021-12-05

文章信息/Info

Title:
Effect of ultrasound-guided percutaneous microwave ablation in treatment of advanced hepatocellular carcinoma
作者:
张 利1姚俊芳2张 磊1褚菲菲1吴慧丽1
(1.郑州大学附属郑州中心医院消化内科,河南 郑州 450007;2.郑州大学附属郑州中心医院超声影像科,河南 郑州 450007)
Author(s):
ZHANG Li1YAO Junfang2ZHANG Lei1CHU Feifei1WU Huili1
(1.Department of Gastroenterology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China;2.Department of Ultrasound,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan Province,China)
关键词:
肝细胞肝癌微波热消融术经导管肝动脉栓塞术超声引导生存率
Keywords:
hepatocellular carcinomamicrowave ablationtranscatheter arterial embolizationultrasound guidancesurvival rate
分类号:
R735.7
DOI:
10.7683/xxyxyxb.2021.12.005
文献标志码:
A
摘要:
目的 探讨超声引导下经皮微波热消融术(MWA)治疗中晚期原发性肝细胞肝癌(HCC)的临床疗效及安全性。方法 选择2014年1月至2018年1月郑州大学附属郑州中心医院收治的141例无法行常规手术切除治疗的中晚期原发性HCC患者为研究对象,根据治疗方式将患者分为MWA组(n=76)和经导管肝动脉栓塞术(TAE)组(n=65),MWA组患者给予超声引导下经皮MWA治疗,TAE组患者给予TAE治疗。比较2组患者的瘤体完全缓解率、术后并发症、肿瘤复发或进展及术后生存情况。结果 术后12个月,MWA组和TAE组患者治疗区瘤体完全缓解率分别为80.0%(152/190)、82.0%(132/161),2组患者治疗区瘤体完全缓解率比较差异无统计学意义(χ2=3.541,P>0.05)。MWA组患者术后肝区胀痛、发热、总胆红素水平升高的发生率分别为15.79%(12/76)、23.68%(18/76)、10.53%(8/76),TAE组患者术后肝区胀痛、发热、总胆红素水平升高的发生率分别为66.15%(43/65)、69.23%(45/65)、49.23%(32/65);MWA组患者术后肝区疼痛、发热、总胆红素水平升高的发生率显著低于TAE组(χ2=11.243、8.264、9.325,P<0.05)。2组患者均无腹腔内大出血、严重腹腔感染、肝衰竭及腹腔种植转移发生。MWA组患者术后6、12、18个月生存率分别为85.53%(65/76)、72.37%(55/76)和46.05%(35/76),中位生存期为15个月;TAE组患者术后6、12、18个月生存率分别为87.69%(57/65)、70.77%(46/65)和47.69%(31/65),中位生存期为16个月;2组患者术后6、12、18个月生存率及中位生存期比较差异均无统计学意义(χ2=1.065、2.684、2.044、1.466,P>0.05)。结论 MWA和TAE治疗中晚期原发性HCC在瘤体完全缓解率、中位生存期、生存率方面效果相当,但MWA术后并发症发生率显著降低。
Abstract:
Objective To investigate the clinical effect and safety of ultrasound-guided percutaneous microwave ablation (MWA) in treatment of advanced primary hepatocellular carcinoma (HCC).Methods A total of 141 patients with advanced primary HCC who couldn′t undergo routine surgical resection in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2014 to January 2018 were selected as the research subjects.The patients were divided into MWA group (n=76) and transcatheter arterial embolization (TAE) group (n=65) according to the treatment methods.The patients in the MWA group were treated with ultrasound-guided percutaneous MWA,and the patients in the TAE group were treated with TAE.The complete remission rate of tumor,postoperative complications,tumor recurrence or progression and postoperative survival were compared between the two groups.Results Twelve months after operation,the complete remission rate of tumor in the treatment area in the MWA group and TAE group was 80.0% (152/190) and 82.0% (132/161),respectively.There was no significant difference in the complete remission rate of tumor in the treatment area between the two groups (χ2=3.541,P>0.05).In the MWA group,the incidences of postoperative liver pain,fever and elevated total bilirubin level were 15.79% (12/76),23.68% (18/76) and 10.53% (8/76),respectively.In the TAE group,the incidences of postoperative liver pain,fever and elevated total bilirubin were 66.15% (43/65),69.23% (45/65) and 49.23% (32/65),respectively.The incidences of postoperative liver pain,fever and elevated total bilirubin in the MWA group were significantly lower than those in the TAE group (χ2=11.243,8.264,9.325;P<0.05).There were no intra-abdominal hemorrhage,severe abdominal infection,liver failure and intraperitoneal implant metastasis in the both groups.The 6-,12- and 18-month survival rates in the MWA group were 85.53% (65/76),72.37% (55/76) and 46.05% (35/76),respectively;and the median survival time was 15 months.The 6-,12- and 18-month survival rates in the TAE group were 87.69% (57/65),70.77% (46/65) and 47.69% (31/65),respectively;and the median survival time was 16 months.There was no significant difference in the 6-,12- and 18-month survival rates and median survival time between the two groups (χ2=1.065,2.684,2.044,1.466;P>0.05).Conclusion MWA and TAE show similar effect on the complete remission rate,median survival time and survival rate of advanced primary HCC,but the incidence of postoperative complications after MWA is significantly reduced.

参考文献/References:

[1] 中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗规范(2019年版)[J].中国实用外科杂志,2020,40(2):121-138.
[2] 闫东.2018《CSCO原发性肝癌诊疗指南》解读:肝动脉介入治疗部分[J].肝癌电子杂志,2018,5(3):4-7.
[3] IKEDA M,KUDO M,AIKATA H,et al.Transarterial chemoembolization with miriplatin vs.epirubicin for unresectable hepatocellular carcinoma:a phase III randomized trial[J].J Gastroenterol,2018,53(2):281-290.
[4] HUO Y R,ESLICK G D.Transcatheter arterial chemoembolization plus radiotherapy compared with chemoembolization alone for hepatocellular carcinoma:a systematic review and meta-analysis[J].JAMA Oncol,2015,1(6):756-765.
[5] ZHANG A M,XIAO Z S,LIU Q F,et al.CaCO3-encapuslated microspheres for enhanced transhepatic arterial embolization treatment of hepatocellular carcinoma[J].Adv Healthc Mater,2021,10(19):e2100748.
[6] LYU N,LIN Y,KONG Y,et al.FOXAI:a phaseⅡtrial evaluating the efficacy and safety of hepatic arterial infusion of oxaliplatin plus fluorouracil/leucovorin for advanced hepatocellular carcinoma[J].Gut,2018,67(2):395-396.
[7] LEE K F,WONG J,HUI J W,et al.Long-term outcomes of microwave versus radiofrequency ablation for hepatocellular carcinoma by surgical approach:a retrospective comparative study[J].Asian J Surg,2017,40(4):301-308.
[8] THAMTORAWAT S,HICKS R M,YU J,et al.Preliminary outcome of microwave ablation of hepatocellular carcinoma:breaking the 3-cm barrier?[J].J Vasc Interv Radiol,2016,27(5):623-630.
[9] MELONI M F,GALIMBERTI S,DIETRICH C F,et al.Microwave ablation of hepatic tumors with a third generation system:loco-regional efficacy in a prospective cohort study with intermediate term follow-up[J].Z Gastroenterol,2016,54(6):541-547.
[10] LIANG P,YU J,LU M D,et al.Practice guidelines for ultrasound-guided percutaneous microwave ablation for hepatic malignancy[J].World J Gastroenterol,2013,19(33):5430-5438.
[11] 张德耀,陈敏山.《2021年欧洲肿瘤内科学会肝细胞癌临床实践指南更新》解读[J].中国医学前沿杂志:电子版,2021,13(8):1-4.DOI:10.12037/YXQY.2021.08-01.
[12] 岳衍晓,宁尚昆,刘吉兵,等.晚期原发性肝癌介入治疗与联合靶向药物治疗效果对比分析[J].中华肿瘤防治杂志,2021,28(10):788-791.
[13] 王洪剑,谢军,刘臣臣,等.TACE联合微波消融术治疗中晚期肝细胞肝癌的疗效[J].川北医学院学报,2021,36(10):1305-1308.
[14] 冯含昕,赵阳,徐锋,等.微波消融技术在肝癌治疗的应用现状和展望[J].中华普通外科学文献:电子版,2020,14(6):458-462.DOI:10.3877/cma.j.issn.1674-0793.2020.06.016.
[15] 程远举,曹君航.肝动脉化疗栓塞术联合超声引导下微波消融术治疗邻近关键部位中晚期肝细胞癌的疗效与安全性观察[J].黑龙江医学,2021,45(5):456-458.

相似文献/References:

[1]丁肖华,毛恺,邱耕,等.反向点杂交检测肝癌细胞DNA 甲基化方法的建立[J].新乡医学院学报,2012,29(01):000.
[2]邱颖谦,陈永林.微小RNA在肝细胞肝癌中的作用研究进展[J].新乡医学院学报,2020,37(9):893.[doi:10.7683/xxyxyxb.2020.09.021]
[3]苏天琳,王中会,晁 旭,等.常规超声联合血清甲胎蛋白评估改良二乙基亚硝胺给药法诱导大鼠肝细胞肝癌模型的可行性[J].新乡医学院学报,2022,39(8):708.[doi:10.7683/xxyxyxb.2022.08.002]
 SU Tianlin,WANG Zhonghui,CHAO Xu,et al.Feasibility of conventional ultrasound combined with serum alpha-fetoprotein in the evaluation of modified diethylnitrosamine administration induced hepatocellular liver cancer model in rats[J].Journal of Xinxiang Medical University,2022,39(12):708.[doi:10.7683/xxyxyxb.2022.08.002]
[4]文正燕,孙传俊,杨献光.混合谱系激酶结构域样蛋白、caspase-8及受体相互作用蛋白激酶3 mRNA在不同阶段乙型肝炎病毒感染患者中的表达及诊断价值[J].新乡医学院学报,2023,40(7):628.[doi:10.7683/xxyxyxb.2023.07.005]
 WEN Zhengyan,SUN Chuanjun,YANG Xianguang.Expression and diagnostic value of mixed lineage kinase domainlike protein,caspase8 and receptor interacting protein kinase 3 mRNA in patients at different stages of hepatitis B virus infection[J].Journal of Xinxiang Medical University,2023,40(12):628.[doi:10.7683/xxyxyxb.2023.07.005]

更新日期/Last Update: 2021-12-05