Pancreatic malignancy is still the most lethal gastrointestinal malignancy.It has a very poor prognosis with low survival rate.Surgery is still the main treatment option for pancreatic malignancy.Most patients already...Pancreatic malignancy is still the most lethal gastrointestinal malignancy.It has a very poor prognosis with low survival rate.Surgery is still the main treatment option for pancreatic malignancy.Most patients already have locally advanced and even late stage disease due to non-specific abdominal symptoms.Even though some cases are still suitable for surgical treatment,due to its aggressiveness adjuvant chemotherapy is becoming the standard treatment for controlling the disease.Radiofrequency ablation(RFA)is a thermal therapy that has been used as one of the standard treatments for liver malignancy.It can also be performed intraoperatively.There are several reports on percutaneous RFA treatment for pancreatic malignancy using transabdominal ultrasound and guided by computed tomography scan.However,due to its anatomical location and the risk of high radiation exposure,these methods seem to be very limited.Endoscopic ultrasound(EUS)has been widely used for pancreatic abnormality evaluation due to its ability to detect more accurately,especially small pancreatic lesions,compared to other imaging modalities.By the EUS approach,it is easier to achieve good visualization of tumor ablation and necrosis as the echoendoscope position is closer to the tumor area.Based on studies and a recent meta-analysis,EUS-guided RFA is a promising treatment approach for most pancreatic malignancy cases,but most studies only collected data from a small sample size.Larger studies are needed before clinical recommendations can be made.展开更多
Objective: To evaluate the hemodynamic changes of hepatic artery (HA), portal vein (PV) and tumors in hepatic cancer patients treated by cluster electrode radio-frequency ablation with the aid of color Doppler flow im...Objective: To evaluate the hemodynamic changes of hepatic artery (HA), portal vein (PV) and tumors in hepatic cancer patients treated by cluster electrode radio-frequency ablation with the aid of color Doppler flow imaging (CDFI). Methods: The hemodynamic changes of HA, PV and 42 tumors in 30 cases of hepatic cancer were investi- gated by CDFI one week before and after cluster e- lectrode radio-frequency ablation. Results: One week after radio-frequency ablation, the velocity of HA decreased (P<0.05), but the dia- meter and velocity of PV unchanged. Before radio- frequency ablation, blood signals were observed in 35 cancer nodes (83.0 % of all 42 nodes). After radio- frequency ablation, blood signals were reduced in 15 nodes and disappeared in 14 nodes. Early investiga- tion implied that the decrease of blood supply was parallel with the reduction of node size. However, the outcome in case of huge nodes with double blood supply was not as promising as those small nodes. Conclusion: CDFI is useful to assess blood supply in ablation of hepatic cancer by using cluster electrode radio-frequency therapy.展开更多
AIM: To explore the role of radio-frequency ablation (RFA) as a treatment for hilar cholangiocarcinoma. METHODS: Eleven patients with obstructive cholestasis underwent Computed Tomography (CT) examination, occupying l...AIM: To explore the role of radio-frequency ablation (RFA) as a treatment for hilar cholangiocarcinoma. METHODS: Eleven patients with obstructive cholestasis underwent Computed Tomography (CT) examination, occupying lesions were observed in the hepatic hilar region in each patient. All lesions were confirmed as cholangioadenocarcinoma by biopsy and were classified as type or by percutaneous transhepatic cholangiography. Patients were treated with multiple electrodes RFA combined with other adjuvant therapy. The survival rate, change of CT attenuation coefficient of the tumor and tumor size were studied in these patients after RFA. RESULTS: In a follow-up CT scan one month after RFA, a size reduction of about 30% was observed in six masses, and two masses were reduced by about 20% in size, three of the eleven masses remained unchanged. In a follow-up CT scan 6 mo after RFA, all the masses were reduced in size (overall 35%), in which the most significant size reduction was 60%. The survival follow-up among these eleven cases was 18 mo in average. Ongoing follow-up showed that the longest survival case was 30 mo and the shortest case was 10 mo. CONCLUSION: RFA is a microinvasive and effective treatment for hilar cholangiocarcinoma.展开更多
AIM: To evaluate a series of patients with hepatocellular carcinoma (HCC) treated with several different protocols and devices.METHODS: We treated 138 patients [chronic hepatitis/liver cirrhosis (Child-Pugh A/B/C), 3/...AIM: To evaluate a series of patients with hepatocellular carcinoma (HCC) treated with several different protocols and devices.METHODS: We treated 138 patients [chronic hepatitis/liver cirrhosis (Child-Pugh A/B/C), 3/135 (107/25/3)]with two different devices and protocols: cool-tip needle [initial ablation at 60 W (standard method) (n=37)or at 40 W (modified method) (n = 28)] or; ablation with a LeVeen needle using a standard single-step, full expansion (single-step) method (n = 39) or a multi-step,incremental expansion (multi-step) method.RESULTS: Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol (60 W) (9/37=24%) and the other two by the LeVeen single-step method (2/39=5%). The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one lobule or both lobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method (40 W) or the LeVeen multi-step method.CONCLUSION: There is a risk of rapid and scattered recurrence after RFA, especially when the standard cooltip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.展开更多
We describe the fabrication of high performance YBa2Cu3O7-δ （YBCO） radio frequency （RF） superconducting quantum interference devices （SQUIDs）, which were prepared on 5 mm×5 mm LaAlO3 （LAO） substrates by ...We describe the fabrication of high performance YBa2Cu3O7-δ （YBCO） radio frequency （RF） superconducting quantum interference devices （SQUIDs）, which were prepared on 5 mm×5 mm LaAlO3 （LAO） substrates by employing stepedge junctions （SEJs） and in flip-chip configuration with 12 mm×12 mm resonators. The step in the substrate was produced by Ar ion etching with step angles ranging from 47° to 61°, which is steep enough to ensure the formation of grain boundaries （GBs） at the step edges. The YBCO film was deposited using the pulsed laser deposition （PLD） technique with a film thickness half of the height of the substrate step. The inductance of the SQUID washer was designed to be about 157 pH. Under these circumstances, high performance YBCO RF SQUIDs were successfully fabricated with a typical flux-voltage transfer ratio of 83 mV/φ0, a white flux noise of 29 μφ0/√Hz, and the magnetic field sensitivity as high as 80 fT/√Hz. These devices have been applied in magnetocardiography and geological surveys.展开更多
Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way an...Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.展开更多
AIM: To evaluate the outcome predictors of percu- taneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the...AIM: To evaluate the outcome predictors of percu- taneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the survival of the patients. METHODS: The study cohort included 153 patients with single (102) and two or three (51) HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection. RESULTS: The Kaplan-Meier estimates of overall 3- and 5-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to Child- Pugh class (P = 0.0275), tumor size (P = 0.0130), serum albumin level (P = 0.0060), serum protein induced by vitamin K absence or antagonist Ⅱ level (P = 0.0486), and initial treatment response (P = 0.0130). The independent predictors of survival were serum albumin level (risk ratio, 3.216; 95% CI, 1.407-7.353; P = 0.0056) and initial treatment response (risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330) based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3- and 5-year survival rates of 86% and 82%. CONCLUSION: In HCC patients treated with percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.展开更多
Background Introperitoneal hemorrhage is one of the most common complications of radiofrequency （RF） ablation of hepatic tumors. This study was designed to investigate the reason and management of intraperitoneal he...Background Introperitoneal hemorrhage is one of the most common complications of radiofrequency （RF） ablation of hepatic tumors. This study was designed to investigate the reason and management of intraperitoneal hemorrhage occurred during or after percutaneous RF ablation of hepatic tumors.Methods Three hundred and flfty-six patients with hepatic tumors have been treated at 592 procedures of ultrasound guided RF ablation. Intraperitoneal hemorrhage occurred in 5 patients （0. 8% ）. The reasons and management of intraperitoneal hemorrhage in these 5 cases were retrospectively analyzed.Results Two patients with liver metastasis and one hepatocellular carcinoma （HCC） patient suffered from hemorrhage during the RF treatment. Two patients with recurrent HCC after surgery developed hemorrhage 20 minutes or 4 hours after RF treatment. One case of hemorrhage was due to the inappropriate electrode positioning induced liver laceration while treating a 1 cm liver metastasis near the liver capsule. One was due to the injury of a small vessel by the RF needle in another liver metastasis patient. Three cases were due to tumor rupture with two cases induced by cough or position change after treating large protruding HCC lesions. Four （80%） of the 5 cases of hemorrhage were rapidly identified by ultrasound. The causes and sites of bleeding during the RF treatment in three cases were confirmed through ultrasound, which were successfully treated using RF coagulation to achieve hemostasis of the bleeding site. Two patients with post-ablation hemorrhage recovered in one hour and 24 hours, respectively after given blood transfusion and other conservative measures. No surgical intervention was required. Two patients died of wide spread metastasis 23-36 months afterwards and the other three patients have lived for 18-25 months to date.Conclusions It is important to perform close monitoring during and after RF ablation in order to identify intraperitoneal hemorrhage in time. RF ablation of the bleeding sites was a simple and effective management when the bleeding site could be confirmed by ultrasound. The hemorrhage due to the rupture of large and protruding liver tumors could be serious and should be considered as contraindication for RF treatment.展开更多
Multiple wavelet hypothesis and fibrillatory conduction are believed to be atrial fibrillation's pathogenesis. Radio frequency ablation(RFA) technique, a therapy for atrial fibrillation(AF), applies radio frequenc...Multiple wavelet hypothesis and fibrillatory conduction are believed to be atrial fibrillation's pathogenesis. Radio frequency ablation(RFA) technique, a therapy for atrial fibrillation(AF), applies radio frequency(RF) energy to targeted tissue to make it transmural. Research on AF ablation has already been conducted in China. Currently, there are single-electrode and dual-electrode ablation electrodes. It is discovered that the latter can reduce the treatment time and maintain the ablation shape of the tissue. Clinical application has shown that it has become the first-line treatment option for part of indications patients with AF.展开更多
Aim:The aim was to assess the impact of hyperglycemia on the recurrence of hepatocellular carcinoma(HCC)as well as evaluate survival after curative ablation by radiofrequency.Methods:This study,which was conducted ret...Aim:The aim was to assess the impact of hyperglycemia on the recurrence of hepatocellular carcinoma(HCC)as well as evaluate survival after curative ablation by radiofrequency.Methods:This study,which was conducted retrospectively on 107 chronic hepatitis C(CHC)patients with 159 HCCs,was presented to the Hepatology Unit of Internal Medicine Department at Tanta University Hospitals.All lesions were curatively treated by radiofrequency ablation(RFA)and the surveillance of HCC recurrence was evaluated radiologically every 3 months for periods between 6 and 36 months.Of 107 subjects,70 were males and 37 were females,with mean age 50.4±9.4 years.All patients were divided according to their glycemic state into the following three groups:Group I,which included 37 type 2 diabetic patients,with adequate maintenance of blood glucose,has 52 HCCs;Group II,which included 25 type 2 diabetic patients with inadequate maintenance of blood glucose,has 43 HCCs;and Group III,which included 45 euglycemic non-diabetic patients,has 64 HCCs.Results:Our results showed that,there was signifi cant increase in recurrence rate in diabetic patients with inadequate maintenance of blood glucose(Group II)compared to those in Group I and Group III(P<0.0001).Interestingly,there was no signifi cant difference concerning HCC recurrence between diabetic patients with adequate maintenance of blood glucose(Group I)and non-diabetic euglycemic patients(Group III).Our results also identifi ed that,inadequate maintenance of blood glucose in diabetic patients was also a signifi cant predictor of poor survival.Conclusion:Inadequate maintenance of blood glucose in diabetic patients is a signifi cant risk factor for recurrence of HCC and for poor survival after curative RFA therapy in CHC patients.展开更多
文摘Pancreatic malignancy is still the most lethal gastrointestinal malignancy.It has a very poor prognosis with low survival rate.Surgery is still the main treatment option for pancreatic malignancy.Most patients already have locally advanced and even late stage disease due to non-specific abdominal symptoms.Even though some cases are still suitable for surgical treatment,due to its aggressiveness adjuvant chemotherapy is becoming the standard treatment for controlling the disease.Radiofrequency ablation(RFA)is a thermal therapy that has been used as one of the standard treatments for liver malignancy.It can also be performed intraoperatively.There are several reports on percutaneous RFA treatment for pancreatic malignancy using transabdominal ultrasound and guided by computed tomography scan.However,due to its anatomical location and the risk of high radiation exposure,these methods seem to be very limited.Endoscopic ultrasound(EUS)has been widely used for pancreatic abnormality evaluation due to its ability to detect more accurately,especially small pancreatic lesions,compared to other imaging modalities.By the EUS approach,it is easier to achieve good visualization of tumor ablation and necrosis as the echoendoscope position is closer to the tumor area.Based on studies and a recent meta-analysis,EUS-guided RFA is a promising treatment approach for most pancreatic malignancy cases,but most studies only collected data from a small sample size.Larger studies are needed before clinical recommendations can be made.
文摘Objective: To evaluate the hemodynamic changes of hepatic artery (HA), portal vein (PV) and tumors in hepatic cancer patients treated by cluster electrode radio-frequency ablation with the aid of color Doppler flow imaging (CDFI). Methods: The hemodynamic changes of HA, PV and 42 tumors in 30 cases of hepatic cancer were investi- gated by CDFI one week before and after cluster e- lectrode radio-frequency ablation. Results: One week after radio-frequency ablation, the velocity of HA decreased (P<0.05), but the dia- meter and velocity of PV unchanged. Before radio- frequency ablation, blood signals were observed in 35 cancer nodes (83.0 % of all 42 nodes). After radio- frequency ablation, blood signals were reduced in 15 nodes and disappeared in 14 nodes. Early investiga- tion implied that the decrease of blood supply was parallel with the reduction of node size. However, the outcome in case of huge nodes with double blood supply was not as promising as those small nodes. Conclusion: CDFI is useful to assess blood supply in ablation of hepatic cancer by using cluster electrode radio-frequency therapy.
文摘AIM: To explore the role of radio-frequency ablation (RFA) as a treatment for hilar cholangiocarcinoma. METHODS: Eleven patients with obstructive cholestasis underwent Computed Tomography (CT) examination, occupying lesions were observed in the hepatic hilar region in each patient. All lesions were confirmed as cholangioadenocarcinoma by biopsy and were classified as type or by percutaneous transhepatic cholangiography. Patients were treated with multiple electrodes RFA combined with other adjuvant therapy. The survival rate, change of CT attenuation coefficient of the tumor and tumor size were studied in these patients after RFA. RESULTS: In a follow-up CT scan one month after RFA, a size reduction of about 30% was observed in six masses, and two masses were reduced by about 20% in size, three of the eleven masses remained unchanged. In a follow-up CT scan 6 mo after RFA, all the masses were reduced in size (overall 35%), in which the most significant size reduction was 60%. The survival follow-up among these eleven cases was 18 mo in average. Ongoing follow-up showed that the longest survival case was 30 mo and the shortest case was 10 mo. CONCLUSION: RFA is a microinvasive and effective treatment for hilar cholangiocarcinoma.
文摘AIM: To evaluate a series of patients with hepatocellular carcinoma (HCC) treated with several different protocols and devices.METHODS: We treated 138 patients [chronic hepatitis/liver cirrhosis (Child-Pugh A/B/C), 3/135 (107/25/3)]with two different devices and protocols: cool-tip needle [initial ablation at 60 W (standard method) (n=37)or at 40 W (modified method) (n = 28)] or; ablation with a LeVeen needle using a standard single-step, full expansion (single-step) method (n = 39) or a multi-step,incremental expansion (multi-step) method.RESULTS: Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol (60 W) (9/37=24%) and the other two by the LeVeen single-step method (2/39=5%). The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one lobule or both lobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method (40 W) or the LeVeen multi-step method.CONCLUSION: There is a risk of rapid and scattered recurrence after RFA, especially when the standard cooltip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.
基金supported by the National Basic Research Program of China(Grant No.2011CBA00106)the National Natural Science Foundation of China(Grant No.11074008)the Research Fund for the Doctoral Program of Higher Education,China(Grant No.20100001120006)
文摘We describe the fabrication of high performance YBa2Cu3O7-δ （YBCO） radio frequency （RF） superconducting quantum interference devices （SQUIDs）, which were prepared on 5 mm×5 mm LaAlO3 （LAO） substrates by employing stepedge junctions （SEJs） and in flip-chip configuration with 12 mm×12 mm resonators. The step in the substrate was produced by Ar ion etching with step angles ranging from 47° to 61°, which is steep enough to ensure the formation of grain boundaries （GBs） at the step edges. The YBCO film was deposited using the pulsed laser deposition （PLD） technique with a film thickness half of the height of the substrate step. The inductance of the SQUID washer was designed to be about 157 pH. Under these circumstances, high performance YBCO RF SQUIDs were successfully fabricated with a typical flux-voltage transfer ratio of 83 mV/φ0, a white flux noise of 29 μφ0/√Hz, and the magnetic field sensitivity as high as 80 fT/√Hz. These devices have been applied in magnetocardiography and geological surveys.
文摘Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.
文摘AIM: To evaluate the outcome predictors of percu- taneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the survival of the patients. METHODS: The study cohort included 153 patients with single (102) and two or three (51) HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection. RESULTS: The Kaplan-Meier estimates of overall 3- and 5-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to Child- Pugh class (P = 0.0275), tumor size (P = 0.0130), serum albumin level (P = 0.0060), serum protein induced by vitamin K absence or antagonist Ⅱ level (P = 0.0486), and initial treatment response (P = 0.0130). The independent predictors of survival were serum albumin level (risk ratio, 3.216; 95% CI, 1.407-7.353; P = 0.0056) and initial treatment response (risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330) based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3- and 5-year survival rates of 86% and 82%. CONCLUSION: In HCC patients treated with percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.
基金This study was supported by a grant from the Foundation of CapitalMedicine Development (No.ZD199909).
文摘Background Introperitoneal hemorrhage is one of the most common complications of radiofrequency （RF） ablation of hepatic tumors. This study was designed to investigate the reason and management of intraperitoneal hemorrhage occurred during or after percutaneous RF ablation of hepatic tumors.Methods Three hundred and flfty-six patients with hepatic tumors have been treated at 592 procedures of ultrasound guided RF ablation. Intraperitoneal hemorrhage occurred in 5 patients （0. 8% ）. The reasons and management of intraperitoneal hemorrhage in these 5 cases were retrospectively analyzed.Results Two patients with liver metastasis and one hepatocellular carcinoma （HCC） patient suffered from hemorrhage during the RF treatment. Two patients with recurrent HCC after surgery developed hemorrhage 20 minutes or 4 hours after RF treatment. One case of hemorrhage was due to the inappropriate electrode positioning induced liver laceration while treating a 1 cm liver metastasis near the liver capsule. One was due to the injury of a small vessel by the RF needle in another liver metastasis patient. Three cases were due to tumor rupture with two cases induced by cough or position change after treating large protruding HCC lesions. Four （80%） of the 5 cases of hemorrhage were rapidly identified by ultrasound. The causes and sites of bleeding during the RF treatment in three cases were confirmed through ultrasound, which were successfully treated using RF coagulation to achieve hemostasis of the bleeding site. Two patients with post-ablation hemorrhage recovered in one hour and 24 hours, respectively after given blood transfusion and other conservative measures. No surgical intervention was required. Two patients died of wide spread metastasis 23-36 months afterwards and the other three patients have lived for 18-25 months to date.Conclusions It is important to perform close monitoring during and after RF ablation in order to identify intraperitoneal hemorrhage in time. RF ablation of the bleeding sites was a simple and effective management when the bleeding site could be confirmed by ultrasound. The hemorrhage due to the rupture of large and protruding liver tumors could be serious and should be considered as contraindication for RF treatment.
基金the Shanghai Science and Technology Research Projects Fund(No.11441900200)the National Key Technology R&D Program(No.2012BAI15B07)
文摘Multiple wavelet hypothesis and fibrillatory conduction are believed to be atrial fibrillation's pathogenesis. Radio frequency ablation(RFA) technique, a therapy for atrial fibrillation(AF), applies radio frequency(RF) energy to targeted tissue to make it transmural. Research on AF ablation has already been conducted in China. Currently, there are single-electrode and dual-electrode ablation electrodes. It is discovered that the latter can reduce the treatment time and maintain the ablation shape of the tissue. Clinical application has shown that it has become the first-line treatment option for part of indications patients with AF.
文摘Aim:The aim was to assess the impact of hyperglycemia on the recurrence of hepatocellular carcinoma(HCC)as well as evaluate survival after curative ablation by radiofrequency.Methods:This study,which was conducted retrospectively on 107 chronic hepatitis C(CHC)patients with 159 HCCs,was presented to the Hepatology Unit of Internal Medicine Department at Tanta University Hospitals.All lesions were curatively treated by radiofrequency ablation(RFA)and the surveillance of HCC recurrence was evaluated radiologically every 3 months for periods between 6 and 36 months.Of 107 subjects,70 were males and 37 were females,with mean age 50.4±9.4 years.All patients were divided according to their glycemic state into the following three groups:Group I,which included 37 type 2 diabetic patients,with adequate maintenance of blood glucose,has 52 HCCs;Group II,which included 25 type 2 diabetic patients with inadequate maintenance of blood glucose,has 43 HCCs;and Group III,which included 45 euglycemic non-diabetic patients,has 64 HCCs.Results:Our results showed that,there was signifi cant increase in recurrence rate in diabetic patients with inadequate maintenance of blood glucose(Group II)compared to those in Group I and Group III(P<0.0001).Interestingly,there was no signifi cant difference concerning HCC recurrence between diabetic patients with adequate maintenance of blood glucose(Group I)and non-diabetic euglycemic patients(Group III).Our results also identifi ed that,inadequate maintenance of blood glucose in diabetic patients was also a signifi cant predictor of poor survival.Conclusion:Inadequate maintenance of blood glucose in diabetic patients is a signifi cant risk factor for recurrence of HCC and for poor survival after curative RFA therapy in CHC patients.
