肝动脉介入栓塞化疗联合射频消融治疗肝癌的临床效果

Clinical study of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of hepatocellular carcinoma

目的评价联合应用肝动脉介入栓塞化疗(TACE)和射频消融(RFA)治疗原发性肝癌的临床疗效。方法经病理、甲胎蛋白化验或影像学证实的符合标准的原发性肝癌123例,按治疗方法随机分为单纯TACE组、单纯RFA组和TACE+RFA组,每组41例。对比观察并随访比较三组短期疗效、治疗后肝功能、血清甲胎蛋白以及1、2、3年期的远期生存率。结果经治疗,三组患者甲胎蛋白、谷丙转氨酶、谷草转氨酶水平均较治疗前均明显降低,且治疗前后差异均具有统计学意义(P<0.05);TACE+RFA组与TACE组、RFA组比较,甲胎蛋白、谷丙转氨酶、谷草转氨酶水平下降幅度更大,差异均有统计学意义(P<0.05)。近期疗效对比,TACE+RFA组为90.24%,TACE组为75.61%,RFA组为70.73%,TACE+RFA组优于单纯TACE组和单纯RFA组,差异均具有统计学意义(P<0.05)。三组远期生存率比较,TACE+RFA组的2、3年生存率和中位生存期显著高于TACE组、RFA组(P均<0.05)。结论 TACE联合RFA治疗原发性肝癌综合疗效优于单纯采用TACE治疗及单纯采用RFA治疗。

Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization(TACE)combined with radiofrequency ablation(RFA)in the treatment of primary hepatocellular carcinoma.Methods 123 cases of primary hepatocellular carcinoma confirmed by pathology,alpha-fetoprotein assay or imaging were randomly divided into TACE group,RFA group and TACE+RFA group.There were 41 cases in RFA group,41 cases in TACE group and 41 cases in TACE+RFA group.The short-term curative effect,liver function,serum alpha-fetoprotein and long-term survival rate of 1,2 and 3 years were observed and compared.Results After treatment,the levels of alpha-fetoprotein,alanine aminotransferase and glutamic oxaloacetic aminotransferase in the three groups were significantly lower than those before treatment(P<0.05).Compared with TACE group and RFA group,the three indicators in TACE+RFA group decreased more significantly(P<0.05).As for short-term efficacy,TACE+RFA group was 90.24%,TACE group was 75.61%,RFA group was 70.73%,the difference was statistically significant(P<0.05).The long-term survival rate of TACE+RFA group was significantly higher than that of TACE group and RFA group(P<0.05).Conclusion The TACE combined with RFA in the treatment of primary hepatocellular carcinoma is better,which has clinical popularization value.