肝动脉栓塞+微波消融治疗距重要脏器<0.5 cm特殊肝癌的安全性及疗效评估

摘要/Abstract

摘要： 目的探讨肝动脉栓塞+微波消融在距脏器<0.5 cm特殊肝癌中的治疗价值。方法选取我院2014年5月—2017年5月收治的距重要脏器<0.5 cm特殊肝癌患者110例。根据病灶部位分成近膈肌组(n=38)、近心脏组(n=32)、近胆囊组(n=40)。选取同期收治的普通部位肝癌患者35例作为对照组。所有患者均采用肝动脉栓塞+微波消融治疗。比较四组的近期疗效,分别在治疗前、复查时检测四组血清特异性生长因子(TSGF)、白蛋白(PAB)、甲胎蛋白(AFP)水平,并观察并发症情况。随访2年,评估四组远期预后。结果膈肌组、近心脏组、近胆囊组、对照组总缓解率分别为73.68%、71.88%、67.50%、82.86%,四组比较无差异(P>0.05)。四组复查时TSGF、AFP较治疗前下降,PAB较治疗前增高(P<0.05),但组间比较无差异(P>0.05)。四组腹腔黏连、胸腔积液、发热率比较无差异(P>0.05)。四组无病生存时间、总生存时间、死亡率比较无差异(P>0.05)。结论肝动脉栓塞+微波消融在距脏器<0.5 cm特殊肝癌患者中适用,近膈肌、近心脏、近胆囊者疗效接近,与普通肝癌者相比疗效无差异,安全性高。

关键词: 特殊肝癌, 肝动脉栓塞, 微波消融, 安全性

Abstract: Objective To investigate the therapeutic value of hepatic artery embolization plus microwave ablation in special hepatocellular carcinoma with the shortest distance between the lesion and organs less than 0.5 cm. Methods One hundred and ten patients with liver cancer in special sites treated in our hospital from May 2014 to May 2017 were selected. According to the location of the lesion, the patients were divided into adjacent diaphragm group (n = 38), adjacent heart group (n = 32) and adjacent gallbladder group (n = 40). Thirty-five patients with hepatocellular carcinoma in common sites admitted in the same period were selected as control group. All patients were treated with hepatic artery embolization combined with microwave ablation. Short-term efficacy of the 4 groups was compared, tumor specific growth factor (TSGF), albumin (ALB) and alpha-fetoprotein (AFP) levels in the 4 groups were detected before and after treatment, and complications were observed. Long-term prognosis was evaluated in the 4 groups after 2 years of follow-up. Results The overall remission rates of adjacent diaphragm group, adjacent heart group, adjacent gallbladder group and control group were 73.68%, 71.88%, 67.50% and 82.86%, respectively. There was no difference among the 4 groups (P>0.05). After treatment, TSGF and AFP decreased and ALB increased in the 4 groups (P<0.05), but there was no difference among the groups (P>0.05). There was no difference in complications rate, disease-free survival time, overall survival time and mortality among the 4 groups (P>0.05). Conclusion Hepatic artery embolization combined with microwave ablation is applicable to patients with liver cancer in special sites < 0.5 cm away from the viscera, with similar efficacy and safety in patients with liver cancer in special and common sites.

Key words: Special liver cancer, Hepatic arterial embolization, Microwave ablation, Security

安军海, 盛银行, 卫春苗, 段国斌. 肝动脉栓塞+微波消融治疗距重要脏器<0.5 cm特殊肝癌的安全性及疗效评估[J]. 肝脏, 2020, 25(10): 1072-1075.

AN Jun-hai, SHENG Yin-hang, WEI Chun-miao, DUAN Guo-bin. Safety and efficacy of hepatic artery embolization plus microwave ablation for special hepatocellular carcinoma less than 0.5 cm away from organs[J]. Chinese Hepatolgy, 2020, 25(10): 1072-1075.

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