经皮射频消融治疗肝脏肿瘤近期疗效观察

Analysis of Short-term Therapeutic Efficacy of Liver Cancer Treated with Percutaneous Radiofrequency Ablation

目的:探讨经皮射频消融(PRFA)对肝脏恶性肿瘤的治疗效果。方法:利用RF-2000^(TM)肿瘤射频治疗系统,在B超或CT引导下对55例肝恶性肿瘤患者73个肿块进行经皮肝穿刺射频热凝治疗,并用B超及CT检查以了解PRFA治疗效果。结果:PRFA治疗后60.9％(42/69)的肿块血供消失,61.6％(45/73)的肿块呈完全凝固性坏死。其中直径小于3 cm中的20个肿块(另4个治疗前即无血供)全部血供消失(100％),24个肿块呈完全凝固性坏死(10％);直径为3～5 cm的18个肿块中16个血供消失(88.9％),14个完全凝固性坏死(77.8％);而直径大于5 cm的肿瘤则治疗后肿块血供完全消失及完全凝固性坏死率均显著降低。肿瘤直径小于5 cm的患者生存期较长。结论:集束电极PRFA治疗肝脏恶性肿瘤创伤小,安全,疗效可靠。肿瘤越小治疗效果越好。

Purpose: To evaluate the efficacy of percutaneous cluster electrode radiofrequency ablation (PRFA) to treat liver cancer. Methods: 55 pa-tients with 73 primary or metastatic liver tumors confirmed by histologically were treated with RF-2000Tm PRFA under ultrasound or CT guidance. The blood supply and coagulation necrosis in the treated tumors were evaluated with ultrasound and CT. Results: Blood supply of tumors was disappeared in 60.9% (42/69) and complete coagulation necrosis of tumors was observed in 61.6% (45/73) after PRFA. The rate of complete blood supply extinction was 100% in 20 tumors that the diameter smaller than 3 cm (another 4 tumors without blood supply before PRFA), and the rate of completely ocncreted necrosis of the 24 tumors (diameter smaller than 3 cm) was 100% . Blood supply was completely disappeared in 88.9% (16/18) tumors and complete coagulation necrosis was observed in 77.8% (14/18) tumors that the diameter between 3 and 5 cm. However, the rate of complete blood supply extinction and coagulation necrosis was significantly lower in the tumors that diameter larger than 5 cm. The patients with tumor that diameter smaller than 5 cm had longer survival time. Conclusion: PRFA is minimally invasive,safe and effective for liver cancer.The smaller the tumor is, the more effective the PRFA efficacy is.