多极射频消融联合TACE治疗巨块型肝癌的疗效

Therapeutic effect of multipolar percutaneous radio-frequency ablation combined with TACE on massive hepatocellular carcinoma

目的与单纯TACE治疗对比,评价多极射频消融(RFA)联合TACE治疗巨块型肝细胞癌(HCC)的疗效。方法将55例经病理、影像学诊断、血清甲胎蛋白(AFP)检查确诊的巨块型HCC患者随机分为两组:联合组27例,接受TACE联合CT导引下RFA治疗;对照组28例,接受单纯TACE治疗。比较两种方法治疗后的总有效率、血清AFP、肝功能等指标。结果治疗术后1、3个月行增强CT扫描,联合组及对照组术后总有效率分别为85.19%、57.14%(P<0.05)。术后2个月联合组血清AFP值由(413.18±354.70)ng/ml降至(80.16±76.64)ng/ml,对照组由(426.81±385.63)ng/ml降至(161.64±132.89)ng/ml(P<0.05)。联合组及对照组治疗后,总胆红素、丙氨酸转氨酶、谷草转氨酶均有一过性增高,术后2周基本恢复至术前水平,两组间比较差异均无统计学意义(P均>0.05)。结论 RFA联合TA-CE治疗巨块型HCC是安全、有效的综合介入治疗方法。

Objective To evaluate the efficacy of multipolar radio-frequency ablation （RFA） in combination with TACE for massive hepatocellular carcinoma （HCC）. Methods Totally 55 patients with massive HCC confirmed by pathology, ra- dio-imaging and the level of serum a-fetoprotein （AFP） were randomly divided into two groups. The combination therapy group （n=27） was treated by TACE in combination with RFA. The control group （n=28） was treated by TACE alone. The parameters of two groups, including tumor total necrosis rate, changes of serum AFP level and liver function were e- valuated and compared after treatment. Results Enhanced CT scanning was performed 1 and 3 months postoperative. To- tal effective rate in combination therapy group and control group was 85.19% and 57.14%, respectively （P〈0.05）. Two months after therapy, AFP in combination therapy group decreased from （413.18 ± 354.70）ng/ml to （80.16±76.64）ng/ml, while in control group from （426.81±385.63）ng/ml to （161.64±132.89） ng/ml （P〈0.05）. total biliru- bin （TBIL）, alanine aminotransferase （ALT） and aspartate aminotransferase （AST） of combination group and control group after therapy both had a temporary increase, but recovered to preoperative levels after 2 weeks （all P〉0.05）. Con- clusion The combining therapy of multipolar RFA and TACE is a safety, effective comprehensive interventional method for massive HCC.