超声引导下微波消融对复发性肝癌长期疗效的影响因素研究

Study on the factors influencing the long-term efficacy of ultrasound-guided microwave ablation for recurrent liver cancer

目的探讨超声引导下微波消融对复发性肝癌长期疗效的影响因素。方法收集2019年9月—2021年9月濮阳市中医医院80例复发性肝癌患者的资料进行回顾性分析,术后随访1年,根据术后1年生存情况将80例复发性肝癌患者分为预后不良组(死亡,22例)及预后良好组(存活,58例)。比较两组临床资料,检测血清甲胎蛋白(AFP)、白蛋白(Alb)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平;通过多因素logistic回归性分析明确影响复发性肝癌患者超声引导下微波消融治疗后长期疗效的因素。结果预后不良组Child-Pugh分级B级、多发病灶、病灶直径≥3 cm、AFP≥100 ng/mL的患者分别为8例(36.36%)、11例(50.00%)、10例(45.45%)、9例(40.91%),与预后良好组8例(13.79%)、12例(20.69%)、13例(22.41%)、10例(17.24%)相比,差异有统计学意义(P<0.05);经多因素logistic回归性分析,Child-Pugh分级B级、多发病灶、病灶直径≥3 cm、AFP≥100 ng/mL是复发性肝癌患者超声引导下微波消融治疗后预后不良的危险因素(P<0.05)。结论对于Child-Pugh分级A级、单发病灶、病灶直径<3 cm、AF P<100 ng/mL的复发性肝癌患者来说,超声引导下微波消融治疗的长期疗效更好。

Objective To investigate the influence factors of ultrasound-guided microwave ablation on the long-term treatment outcomes of recurrent liver cancer.Methods We collected data from 80 patients with recurrent liver cancer treated at our hospital from September 2019 to September 2021 and conducted a retrospective analysis.The patients were divided into a poor prognosis group(22 deaths)and a good prognosis group(55 survivals)based on their 1-year postoperative survival.Clinical data were compared between the two groups,including serum levels of alpha-fetoprotein(AFP),albumin(Alb),alanine aminotransferase(ALT)and aspartate aminotransferase(AST).Multiple Logistic regression analysis was conducted to identify the factors influencing the long-term efficacy of ultrasound-guided microwave ablation in patients with recurrent liver cancer.Results In the poor prognosis group,8 cases(36.36%)of patients were classified as Child-Pugh grade B,11 cases(50.00%)had multiple lesions,10 cases(45.45%)had lesion diameter≥3 cm,and 9 cases(40.91%)had AFP≥100 ng/mL.In comparison,the good prognosis group had 8 cases(13.79%)with Child-Pugh grade B,12 cases(20.69%)with multiple lesions,13 cases(22.41%)with lesion diameter≥3 cm,and 10 cases(17.24%)with AFP≥100 ng/mL.These differences were found to be statistically significant(P<0.05).Multivariate Logistic regression analysis further confirmed that Child-Pugh grade B,multiple lesions,lesion diameter≥3 cm,and AFP≥100 ng/mL were identified as risk factors for a poor prognosis in patients with recurrent liver cancer after ultrasus-guided microwave ablation(P<0.05).Conclusion Ultrasound-guided microwave ablation has better long-term efficacy for patients with Child-Pugh grade A,single lesion,lesion diameter<3 cm,and AFP<100 ng/mL.