原发性肝癌冷循环射频治疗术后针道种植转移的诊断与治疗

DIAGNOSIS AND TREATMENT OF NEOPLASTIC NEEDLE TRACT SEEDING FOLLOWING RADIOFREQUENCY ABLATION OF PRIMARY HEPATIC CARCINOMA

目的明确原发性肝癌射频消融术后针道种植转移的发生率及相关危险因素。方法对2001年至2010年于我院接受冷循环射频治疗的400位患者(700个病灶)的临床资料进行回顾性分析。结果 4位患者术后发生针道转移1%(4/400),均经影像检查或再次外科手术予以证实。其中3例为皮下转移,予以局部切除治疗,一例右肝内复发合并右侧胸壁种植转移,予以右半肝切除及右侧胸壁种植灶局部切除处理,术后AFP均明显下降,术后存活分别为6月,13月,4月,4月。结论射频术后可能导致针道转移。手术切除可以取得良好的治疗效果。

Objective To identify the diagnosis and treatment of neoplastic needle tract seeding following radiofrequency ablation of primary hepatic carcinoma.Methode Analysis the clinic data of 400 cases（700 lesions） of primary hepatic carcinoma received radiofrequency ablation from 2001 to 2010 retrospectively.Result There are 4 cases（1%） of neoplastic needle tract seeding totally,all of them were identified by computed tomography or pathological examination.3 cases were subcutaneous neoplastic seeding,received local resection;recurrence in right hepatic lobe and right chest wall neoplastic seeding happened in 1 case,the patient received right hepatectomy combined local resection of right chest wall,the level of AFP decreased significantly.postoperative survive are 6 months,13months,4months and 4 months respectively.Conclusion Needle track seeding can happen after RFA of primary hepatic carcinoma,surgical excision with a wide margin seems to be the most justifiable option.