射频消融术和腹腔镜肝切除术治疗复发性肝癌的临床疗效及远期生存情况分析

Clinical efficacy and long-term survival of radiofrequency ablation and laparoscopic hepatectomy in the treatment of recurrent liver cancer

目的探讨射频消融术(RFA)和腹腔镜肝切除术(LH)治疗复发性肝癌的临床疗效及远期生存情况。方法依据随机数字表法将58例复发性肝癌患者分为LH组(接受LH治疗)和RFA组(接受RFA治疗),每组29例。比较治疗前和治疗后4周两组患者的血清肝功能指标[总胆红素(TBIL)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)]和肿瘤标志物[癌胚抗原(CEA)、磷脂酰肌醇蛋白聚糖3(GPC3)、甲胎蛋白(AFP)]水平,比较两组患者术后并发症发生率及3年生存情况。结果治疗前,两组患者的血清TBIL、AST、ALT、CEA、GPC3、AFP水平比较,差异均无统计学意义(P﹥0.05)。治疗后4周,RFA组患者的血清ALT、AST水平均高于LH组,差异均有统计学意义(P﹤0.05)。LH组患者的并发症总发生率为20.69%,高于RFA组的3.45%,差异有统计学意义(P﹤0.05)。两组患者的3年无进展生存情况和总生存情况比较,差异均无统计学意义(P﹥0.05)。结论对于复发性肝癌,LH与RFA治疗具有相似的长期疗效,但RFA治疗的安全性较好。

Objective To investigate the clinical efficacy and long-term survival of radiofrequency ablation(RFA)and laparoscopic hepatectomy(LH)in the treatment of recurrent liver cancer.Method According to a random number table,58 patients with recurrent liver cancer were included and divided into LH group(receiving LH)or RFA group(receiving RFA),with 29 cases in each group.Before treatment and 4 weeks after treatment,the serum liver function indicators[total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]and tumor markers[carcinoembryonic antigen(CEA),glypican 3(GPC3),α-fetoprotein(AFP)]levels,as well as the incidence of postoperative complications and 3-year survival in the two groups were compared.Result Before treatment,there were no statistical differences in serum levels of TBIL,ALT,AST,CEA,GPC3 and AFP between the two groups(P>0.05).While at 4 weeks after treatment,the levels of ALT and AST in RFA group were higher than those in LH group,the difference was statistically significant(P<0.05).The overall incidence of complications in LH group(20.69%)was significantly higher than that in the RFA group(3.45%),with statistically significant difference noted(P<0.05).The 3-year progression-free survival and overall survival were similarly comparable between the two groups(P>0.05).Conclusion For recurrent liver cancer,LH and RFA treatment showed similar long-term efficacy,while RFA conveys relatively better safety.