经皮射频消融治疗肝脏肿瘤

Radio-frequency ablation of liver tumor

[目的]探讨经皮射频消融术(RFA)治疗肝脏肿瘤的临床应用价值。[方法]215例经穿刺活检病理证实的肝脏肿瘤患者(原发性肝癌155例,转移性肝癌52例,肝腺瘤1例,肝血管瘤7例)均行在CT引导下的RFA治疗。所有患者的肝内病灶最大径均≤5 cm。同时所有患者均在RFA治疗前,治疗后(1周、1月、3月、6月)行CTA或MR I及免疫指标来评价疗效。[结果]所有肝脏恶性肿瘤患者(207例),术后的影像学上均可见病灶局部坏死、气化,1周至6个月的复查,189例患者未见肿瘤复发征象,18例可见原病灶内及周围有复发征象;同时,AFP、CEA等免疫指标均明显下降。肝脏良性肿瘤的患者,术后在影像学上亦均表现局部坏死、气化,同时复查的增强扫描均未再发现病灶区有明显的强化。[结论]经皮射频消融术在肝脏肿瘤的治疗中占有重要的位置,是一种安全有效的治疗方法。

[ Objective] To investigate the clinical efficacy of radio- frequency ablation in the treatment of liver tumor. [ Methods ] In all the 215 cases of liver tumor（ 155 primary hepatic tumor,52 hepatic metastases, 1 hepatic adenoma,7 hepatic hemangioma） which were confirmed by biopsy were treated by RFA guiding with CT. All the maximal diameter of lesion were less than 5 cm. And the level of AFP and CEA ,the CTA or MRI of liver were all used for investigation（ pre and post RFA）. [ Results] All the malignant liver tumor （207 cases） showed local necrosis and some air bubbles in the lesion post -RFA. And the follow- up study showed 189 cases no tumor manifestation in CT or MRI, also in the level of AFP and CEA. The benign tumor also had the same manifestations in the imaging. 18 cases showed local recurrence. [ Conclusion] The RFA is an effective and safe method in the treatment of liver tumor.