冷水循环型微波热疗治疗肝癌126例的疗效评价

Cooled-tip electrode microwave ablation for the treatment of hepatocellular carcinoma

目的探讨冷水循环型微波（microwave，MW）热疗治疗肝癌的近期疗效及安全性。方法用FORSEAMTC-3冷水循环型微波肿瘤热疗仪治疗肝癌126例，通过血清AFP水平，影像学检查，随访等指标观察疗效。结果22例AFP升高的原发性肝细胞肝癌（hepatocellularcarcinoma，HCC）患者，MW治疗后AFP均恢复至或接近正常值，治疗前AFP平均为（102.2±23．5）ng／ml，热疗后为（25．6±3．7）ng／ml（t=2，1，P〈0.05）。MW治疗区在增强CT扫描各期均无强化，以门静脉（portalvein，PV）期最明显，而周边可见很薄的环形强化，治疗的坏死范围大于治疗前病灶范围。单点穿刺可获得5.5cm×4．5cm的有效热疗区；2点穿刺可获得7．5cm×5．5cm的有效热疗区；3点穿刺可获得9.5cm×9cm的有效热疗区。1年前经MW治疗的肝癌患者57例，其1年生存率为89，5％（51／57）。MW治疗肝癌并发症少，多为发热、肝功能异常、胸水等，偶见肝脓肿，无1例手术死亡。结论MW热疗可以作为肝癌的一种安全有效的微创治疗方法。

Objective To evaluate short-term therapeutic efficacy and safety of cooled-tip electrode microwave ablation for hepatocelhdar carcinoma （ HCC ）. Methods In this study, 126 HCC patients were treated with a new cooled-tip electrode microwave （ FORSEA MTC-3 ）. The level of AFP, contrast-enhanced CT and follow-up data were used to evaluate the short-term therapuetic efficacy. Results In 22 cases, the pretreatment AFP level （102. 2 ±_23.5） ng/ml significantly decreased （25.6 ±3.7） ng/ml （ t = 2. 1, P 〈 0. 05 ） ; The ablated area was not enhanced on contrast-enhanced CT, the tissue around ablated area was enhanced. The ablated area was 5. 5 cm × 4.5 cm × 4 cm with single electrode ablation, 7. 5 cm × 5.5 cm × 5. 5 cm with two electrode ablation, and 9. 5 cm× 9 cm × 9 cm with three electrode ablation; Postoperative 1 year survival rate is 89.5% （51/57）; There were a few complications occurred such as fever, liver function abnormality, and liver abscess. There was no mortality in this group. Conclusion The innovated microwave ablation is safe and effective for the treatment of HCC.