超声引导经皮穿刺微波消融治疗肺癌

Ultrasound-guided percutaneous microwave ablation of lung cancer

目的探讨超声引导经皮穿刺微波消融治疗周围型肺癌的疗效及可行性。方法对17例周围型肺癌的23个肿瘤结节行超声引导微波消融治疗,先用60W、100s,然后30～40W、300～600s,直径≥3cm的肿瘤一次多点凝固。结果微波消融治疗后肿瘤结节均有缩小,内部血流信号消失(14个结节)或减少(9个结节);增强CT检查16个肿瘤结节无强化,7个部分强化;4例活检治疗区肿瘤完全坏死。微波消融治疗后1个月8例临床症状消失,9例症状减轻。15例随访6～47个月,平均23个月,9例存活,无严重并发症发生。结论超声引导微波消融治疗周围型肺癌安全、可行、有效。

Objective To evaluate the efficacy and feasibility of ultrasound-guided percutaneous microwave ablation for peripheral lung cancer. Methods Seventeen patients with peripheral lung cancer （23 nodules） were treated with ultrasound-guided microwave ablation. The microwave energy was initially set at 60 W for 100s, and then at 30 - 40 W for 300 - 600 s. The treatment was conducted by using multiple simultaneously-powered antennas in lesions ≥ 3 cm in diameter. Results After the treatment, all the nodules were decreased in size and the blood flow signals inside the nodule disappeared （14 nodules） or weakened （9 nodules）. Enhanced CT scanning revealed no enhancement in 16 nodules and partial enhancement in 7. Repeated biopsy in 4 patients showed a complete tumor necrosis. Clinical symptoms disappeared in 8 patients and subsided in 9 patients 1 month after treatment. Follow-up observations in 15 patients for 6 - 47 months （ mean, 23 months） showed 9 survivors, without serious complications. Conclusions Ultrasound-guided percutaneous microwave ablation is an effective, safe, and feasible method for treating peripheral lung cancer.