经皮穿刺热消融术在肝细胞癌中的临床应用进展

Advances in clinical application of percutaneous thermal ablation for hepatocellular carcinoma

经皮穿刺热消融术是一种微创介入治疗技术,在肝细胞癌的各临床分期治疗中均发挥着重要作用。对于早期中央型肝癌,热消融术作为根治性且微创的方法更为推荐。对于中期肝癌,有转化为根治机会者,可以通过经肝动脉化疗栓塞减瘤后再消融达到根治;对于不易转化为根治者,同步热消融联合动脉化疗栓塞可减少栓塞剂用量,相比常规动脉栓塞化疗可延长患者的无进展生存期和总生存期。对于晚期肝癌,热消融可使局部肿瘤坏死并可增加肿瘤相关抗原释放,有增敏免疫治疗效果的作用。

As a minimally-invasive interventional treatment technique,percutaneous tumor thermal ablation plays an important role in treating hepatocellular carcinoma(HCC)of various clinical stages.For early HCC of central type,thermal ablation,as a radical and minimally-invasive method,has been widely recommended in clinical practice.For patients with mid-stage HCC carrying a chance of transforming into a radical cure,transhepatic arterial chemoembolization(TACE),which can reduce the tumor load,combined with subsequent thermal ablation can achieve the goal of radical cure.For HCC patients having no chance of transforming into a radical cure,simultaneous thermal ablation and TACE therapy can reduce the used amount of embolic agents,and this combination therapy can prolong the progression-free period and overall survival time when compared with simple conventional TACE treatment.For patients with advanced HCC,thermal ablation can cause local tumor necrosis and increase the release of tumor antigens,which can enhance the curative effect of immunotherapy.(J Intervent Radiol,2022,31:1224-1227)