超声引导下经皮射频消融治疗恶性肿瘤肝转移

Ultrasound-guided percutaneous radiofrequency ablation in treatment of liver metastases of malignant tumor

目的探讨超声引导下经皮射频消融(RFA)治疗恶性肿瘤肝转移的应用价值。方法回顾性分析2009年12月—2015年5月于我院接受超声引导下经皮RFA治疗的109例恶性肿瘤肝转移患者的临床及影像学资料。结果 109例肝转移癌患者中,单发31例(31/109,28.44%),多发78例(78/109,71.56%);肝转移病灶来源于结直肠、肺、乳腺、胃、胰腺、卵巢及前列腺的恶性肿瘤。共198个肝转移癌病灶中,直径<3cm者151个(151/198,76.26%),直径≥3cm者47个(47/198,23.74%)。治疗后1个月,187个(187/198,94.44%)病灶完全灭活,11个(11/198,5.56%)病灶存在残余活性。与治疗前比较,治疗后1个月患者肿瘤标志物指标明显改善(P均<0.05)。术中及术后并发症发生率6.42%(7/109)。结论对于非手术适应证恶性肿瘤肝转移患者,超声引导下经皮RFA治疗相对安全、有效,短期内可局部控制肝内转移癌的活性。

Objective To investigate the application value of ultrasound-guided percutaneous radiofrequency ablation （RFA） in treatment of liver metastases of malignant tumor. Methods Clinical and imaging data of 109 patients with liver metastases of malignant tumor who underwent ultrasound-guided percutaneous RFA during December 2009 to May 2015 were retrospectively analyzed. Results There were 31 patients （31/109, 28.44%） with single liver metastases and 78 pa- tients （78/109, 71.56o//oo） with multiple lesions. The primary tumors included colorectal, lung, breast, gastric, pancreatic, ovarian and prostate carcinomas. Among all 198 liver metastases, there were 151 （151/198, 76.26%） with diameter 3 cm and 47 （47/198, 23.74%） with diameter ≥3 cm. One month after RFA, 187 lesions （187/198, 94.44%） were com- pletely inactivated, while the other 11 lesions （11/198, 5.56%） still had residual activity. One month later, the tumor markers improved obviously compared with those before treatment （all P〈0.05）. The incidence of intraoperative and post- operative complications was 6.42% （7/109）. Conclusion Ultrasound-guided percutaneous RFA is a safe and effective treatment for patients with non-surgical indications of malignant liver metastases, which can partially control the survival activity of liver metastases.