超声融合导航技术指导微波消融治疗小肝癌临床价值研究

Short-term clinical efficacy of microwave ablation under the guidance of ultrasound fusion imaging in the treatment of patients with small primary liver cancer

目的研究应用超声融合导航技术在常规超声检查显示困难的小肝癌患者引导微波消融(MWA)治疗的价值。方法2018年1月~2022年1月我院诊治的80例原发性肝癌(PLC)患者,其中接受经皮肝动脉导管化疗栓塞术(TACE)治疗40例,接受在超声融合导航技术指导下MWA治疗40例,术后随访。采用ELISA法检测血清甲胎蛋白(AFP)和热休克蛋白-90(Hsp-90)水平。结果在治疗后1个月复查,MWA治疗组完全缓解率为82.5%,显著高于TACE治疗组的37.5%,差异有统计学意义(P<0.05);在治疗后3个月,MWA治疗组血清AFP和Hsp90水平分别为(15.2±9.3)μg/L和(63.5±7.8)ng/ml,显著低于TACE治疗组【分别为(32.6±10.2)μg/L和(88.4±9.1)ng/ml,P<0.05】;术后,MWA治疗组肝区疼痛发生率为47.5%,显著低于TACE治疗组的82.5%,差异有统计学意义(P<0.05)。结论采用超声融合导航技术指导常规超声检查显示困难的小肝癌微波消融治疗可提高肝癌病灶完全消融率,减少术后不良反应,值得进一步研究。

Objective The aim of this study was to investigate the short-term clinical efficacy of microwave ablation(MWA)under the guidance of ultrasound fusion imaging in the treatment of patients with small primary liver cancer(sPLC).Methods 80 patients with sPLC were admitted to our hospital between January 2018 and January 2022,and were divided into two groups,with 40 cases in each group.The patients in the observation group received MWA treatment under the ultrasound fusion imaging guidance,and those in the control group received transcatheter arterial chemoembolization(TACE).Serum alpha-fetoprotein(AFP)and hot-shock protein-90(HSP-90)levels were assayed by ELISA.Results At the end of one month treatment,the complete response rate in MWA-treated patients was 82.5%,much higher than 37.5%in TACE-treated patients(P<0.05);at the end of three month treatment,serum AFP and HSP-90 levels in MWA-treated patients were(15.2±9.3)μg/L and(63.5±7.8)ng/ml,significantly lower than[(32.6±10.2)μg/L and(88.4±9.1)ng/ml,respectively,P﹤0.05]in TACE-treated patients;after operation,the incidence of local pain in MWA-treated patients was 47.5%,much lower than 82.5%in TACE-treated patients(P<0.05).Conclusions The application of MWA under the guidance of ultrasound fusion imaging in the treatment of patients with sPLC is efficacious,which could improve the complete ablation rate of lesions,and worthy of clinical verification.