经皮氩氦刀冷冻治疗肝细胞癌的安全性和疗效

Percutaneous argon-helium cryoablation for hepatocellular carcinoma:safety and efficacy

肝细胞癌(hepatocellular carcinoma,HCC)居世界癌症死因第三位,在中国居第二位。手术切除率仅为20%～30%,因供体缺乏,肝移植术明显受限,因此多种局部消融术,如无水酒精、射频、激光、高强度聚集超声、微波和冷冻消融等在HCC治疗中发挥着重要作用。氩氦超导靶向手术系统(氩氦刀)冷冻治疗HCC是近年发展的一项局部消融术,尽管在中国经皮氩氦刀治疗HCC已有较多应用,但世界范围内对该技术尚存争议。与应用广泛的射频消融术及其他热消融技术相比,氩氦刀冷冻治疗有产生较大的毁损面积及更为清晰可辨的治疗区域等优势。本文对经皮氩氦刀冷冻治疗HCC的适应证、技术、患者管理、安全性及疗效进行评述。

Hepatocellular carcinoma （HCC） is ranked the third most common cause of cancer-related death worldwide and the second in China. The resectability rate of HCC is only 20%-30%. Liver transplantation is limited by the availability of donor organs, therefore, local ablative therapies, such as ethanol injection therapy, radiofrequency ablation （RFA）, laser photocoagulation, highintensity focused ultrasound, microwave and cryoablation play an important role in the management of HCC. Argon-helium cryoablation is a new local ablation modality. However, percutaneous cryoablation of HCC is less well studied beeause of the bias against percutaneous setting worldwide in spite of its application in China. Compared to RFA and other heat-based modalities, argon-helium cryoablation has several advantages, such as the ability to produce larger and more precise zones of ablation. This review focuses on the indications, techniques, patient management, safety and efficacy associated with pereutaneoos cryoablation of HCC.