高强度聚焦超声治疗肝细胞癌的疗效及其影响因素

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

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.

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 function were 83.2% （80/104） and 82.7% （86/104）, respectively, and the patients with AFP decreased by more than 50% covered a percentage of 62.5% （65/104）. After HIFU, color Doppler sonography 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 treatment. CONCLUSION： HIFU is effective and feasible in the treatment of HCC, and its efficacy is associated with the pretherapeutic AFP levels, TNM stages and treatment combined with transcatheter arterial chemoembolization and metastasis.