超声引导下热消融治疗肝少见肿瘤疗效初步探讨

Clinical efficacy of ultrasound-guided thermal ablation in treatment of rare liver tumors

目的探讨超声引导下热消融治疗肝少见肿瘤的安全性和疗效。方法回顾性分析2012年1月至2016年12月在中山大学附属第三医院行超声引导下热消融的9例肝少见肿瘤患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男2例,女7例;平均年龄(42±12)岁。9个病例共14个病灶。所有患者均在超声或超声造影引导下肝肿瘤穿刺,行热消融治疗。术中超声造影即时评估消融疗效,观察术后并发症发生率等。CT、MRI评价术后1个月完全消融率。结果 11个病灶在普通超声引导下消融,3个病灶在超声造影引导下消融。术中肿瘤完全消融率为14/14,术后1个月肿瘤完全消融率亦为14/14。无消融相关并发症发生。随访期间所有患者均未出现局部肿瘤进展及肝内外肿瘤复发。结论对于肝少见肿瘤,超声引导下热消融可达到完全消融的效果,为此类患者提供了新的治疗选择。

Objective To investigate the safety and efficacy of ultrasound-guided thermal ablation in the treatment of rare liver tumors. Methods Clinical data of 9 patients with rare liver tumors who underwent ultrasound-guided thermal ablation from January 2012 to December 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among 9 cases （14 lesions）, 2 patients were male and 7 female, aged （42±12） years on average. All the patients underwent ultrasound or contrast-enhanced ultrasound-guided puncture and thermal ablation of the tumors. The ablation effect was evaluated immediately by contrast-enhanced ultrasound during the operation. The incidence of postoperative complications was observed. The complete ablation rate was evaluated by CT or MRI at postoperative 1 month. Results 11 lesions were treated with common ultrasound-guided thermal ablation and 3 lesions with contrast-enhanced ultrasound-guided ablation. The intraoperative complete ablation rate was 100% （14/14）, and the rate at postoperative 1 month was also 100% （14/14）. No ablation related complications was observed. During the follow-up, no local tumor progression or intrahepatic and extrahepatic tumors recurrence was observed in all patients. Conelusions For rare liver tumors, ultrasound-guided thermal ablation can achieve the effect of complete ablation, providing a new therapeutic option for the patients.