经皮肝穿刺氩氦刀冷冻治疗第二肝门区小肝癌

PERCUTANEOUS CRYOABLATION FOR LIVER CANCER LOCATED IN THE SECOND HEPATIS

目的探讨B超引导氩氦刀冷冻治疗第二肝门区小肝癌的技术可行性、疗效和安全性。方法2002年10月至2006年6月选择肿瘤位于第二肝门区、直径≤5cm、病理或临床证实为原发性或继发性肝癌的8例患者进行氩氦刀冷冻治疗。治疗前甲胎蛋白(AFP)阳性者治疗后定期复查AFP。治疗后1个月复查MRI或CT确定肿瘤是否完全坏死,以后每3个月定期复查。结果AFP转阴率约为75%,MRI或CT显示第一肝门区肿瘤完全凝固坏死率为62.5%。术后0.5、1年无原位复发生存率均为100%、87.5%;血管壁损伤或大出血发生率为0%。结论第二肝门区小肝癌并非氩氦刀冷冻治疗的禁忌症,只要治疗时穿刺点选择恰当、穿刺路径合理、范围控制恰当,对于第二肝门区小肝癌是一种行之有效的治疗方法。

Objective To explore the feasibility, effect and problems of percutaneous cryoablation performed for small liver cancer located in the second hepatis. Methods Eight patients, who had small primary or metastatic liver cancer confirmed clinically or pathologically that were located in the second hepatis and less than 5cm, were performed between April 2002 and June 2006. All patients were followed up to examine the value of AFP,MRI or CT. Results The rate of AFP positive down to negative was 75%. The complete necrosis rate was 62. 5%. Peri-tumor recurrence free survival rates of 0. 5,1 year were 100% ,87.5% respectively. Conduslons Small liver cancer located in the second hepatis was not the contraindication of cryoablation. If the puncture point and route is selected properly and the range of cryoablation controlled appropriately, It is an effective method and of less complication rate for small liver cancer located in the second bepatis.