CT引导下PAI治疗原发性小肝癌远期疗效分析

Long-term curative effect of CT-guided percutaneous acetic acid injection in primary small hepatocellular carcinoma

目的探讨CT引导下瘤内注射乙酸治疗原发性小肝癌的远期疗效。方法对27例(35个病灶)原发性小肝癌患者行CT引导下直接瘤内注射乙酸治疗,术后随访10～60个月,动态监测肿瘤治疗后CT表现和患者存活时间。结果对27例患者(35个病灶)共实施79次治疗,穿刺成功率100%;肿瘤坏死率为100%;1、2、3、4、5年存活率分别为96.30%(26/27)、88.89%(24/27)、77.78%(21/27)、62.96%(17/27)、37.04%(10/27)。PAI主要并发症为局部疼痛和局限性腹膜炎等。结论肿瘤分化好,体积小者及单病灶者存活时间长。CT引导下PAI治疗SHCC疗效安全可靠、微创,可作为非手术治疗小肝癌的首选方法之一。

Objective To evaluate the long-term curative effect of CT-guided percutaneous acetic acid injection（PAI） of primary small hepatocellular carcinoma（SHCC）.Methods A total of 27 patients with 35 nodules of SHCC（diameter ≤3 cm） underwent CT-guided PAI,including 21 with single nodule and 6 with 2 or 3 nodules.Results CT-guided PAI was performed 79 times on 35 nodules in 27 patients.The successful puncture rate of all nodules was 100%.The necrosis rate of nodules was 100%.The 1,2,3,4 and 5-year survival rate was 96.30%（26/27）,88.89%（24/27）,77.78%（21/27）,62.96%（17/27）,and 37.04%（10/27）,respectively.Major complications included local pain and chemical peritonitis.Conclusion CT-guided PAI is obviously safe and effective,minimally invasive method for SHCC,and should be used as one of the first choices for non-operative treatment of SHCC.