肝切除、射频消融和肝移植三种方案治疗小肝癌的临床疗效比较

Clinical effect of resection,radiofrequency ablation and transplantation for small hepatocellular carcinoma:Comparative study

目的对小肝癌(小肝细胞癌)的3种常用外科治疗方法进行疗效比较,为小肝癌的临床治疗方案选择提供参考。方法选取2006年1月—2015年12月解放军401医院外科治疗的660例小肝癌病例进行研究。根据肿瘤直径分为0~2.0 cm、2.1~3.0 cm、3.1~5.0 cm和多发组,根据治疗方案分为肝切除组、射频消融组和肝移植组。比较各组之间整体生存时间和整体生存率、无瘤生存时间和无瘤生存率的差异。结果在0~2.0 cm组和2.1~3.0 cm组中,肝切除和射频消融的疗效相当,而肝移植的疗效优于肝切除和射频消融(P<0.05);在3.1~5.0 cm组中,肝移植的疗效最优,肝切除次之,射频消融效果最差(P<0.05);在多发组中,肝切除和射频消融的疗效相当,而肝移植的疗效优于肝切除和射频消融(P<0.05)。结论小肝癌瘤体的直径和数目对治疗方案的选择具有重要的临床意义,其中肝移植治疗小肝癌疗效最佳。

Objective To analyse the theraputic effect of commom surgical strategies,so as to provide reference for the clinical treatment of small hepatocellular carcinoma.Methods From January2006to December2015,660patients with small hepatocellular carcinoma who underwent surgical treatment at author's hospital were included in this study and divided into four trial groups according to tumor diameter,then divided into three treatment groups according to surgical strategy in each classification group.Overall survival time and overall survival rate,tumor-free survival time and tumor-free survival rate were compared between the treatment groups.Results In the0-2.0cm group and2.1-3.0cm group,the curative effect was similar between resection and radiofrequency ablation,but liver transplantation had better effect than resection and radiofrequency ablation(P<0.05);In3.1-5.0cm group,liver transplantation had the best effect,and resection was superior to radiofrequency ablation(P<0.05);the curative effect was similar between resection and radiofrequency ablation,but liver transplantation had better effect than resection and radiofrequency ablation(P<0.05).Conclusion The diameter and number of small sized HCC have important clinical significance for treatment choice,in which liver transplantation has the best curative effect.