肝脏硬度对肝细胞癌射频消融疗效的影响

Clinical study of the effect of liver stiffness on treatment efficacy of radiofrequency ablation in hepatocellular carcinoma patients

目的研究肝脏硬度对肝细胞癌(HCC)射频消融疗效的影响。方法 2014年10月至2017年2月行超声引导射频消融治疗HCC患者,共106例114个结节。治疗前采用肝纤维化扫描仪(FibroScan)对患者肝脏行硬度测量,根据检测记录,将患者分为高LSM组和低LSM组。统计分析两组患者的疗效差异。结果治疗后1个月复查,高LSM组与低LSM组分别有67和41个结节完全灭活,两组结节完全灭活率分别为94.4%和95.3%(P=0.88);随访期间,高LSM组和低LSM组分别有13个、3个结节发生局部复发,局部复发率分别为16.9%、7.0%;高LSM组和低LSM组患者分别有18例、4例发生肝内复发,肝内复发率分别为28.4%、10.3%,两组间差异均有统计学意义。结论肝脏硬度是HCC射频消融治疗后发生局部复发和肝内复发的影响因素。

Objective To analyze the effect of liver stiffness on treatment efficacy of radiofrequency ablation in hepatocellular carcinoma（HCC）patients.Methods From October 2014 to February 2017,there were 106 patients with114 nodules receiving ultrasound-guided radiofrequency ablation in our hospital.Liver stiffness measurement（LSM）value was measured by FibroScan before treatment and patients were divided into high-LSM group and low-LSM group with a cutoff value of 17.6 kPa.Differences of complete necrosis rate,local tumor progression rate and intrahepatic recurrence rate between the two groups were analyzed.Results The complete necrosis rates of high-LSM group and low-LSM group were94.4% and 95.3%,respectively,which showed no statistical difference（P=0.88）.The local tumor progression rates and intrahepatic recurrence rates were significantly lower in high-LSM group than those in low-LSM group（16.9% vs.28.4%,P=0.03 and7.0% vs.10.3%,P=0.02,respectively）.Conclusion LSM value could be a useful predictor for local tumor progression and intrahepatic recurrence after radiofrequency ablation in HCC patients.