超声新技术辅助大血管旁小肝癌精准微波消融治疗效果观察

肝脏 ›› 2023, Vol. 28 ›› Issue (8): 932-934.

超声新技术辅助大血管旁小肝癌精准微波消融治疗效果观察

张海荣, 李劲松, 田秀丽, 何鑫, 姜珏

710020 西安宝石花长庆医院功能科(张海荣,李劲松,田秀丽);西安交通大学第二附属医院超声研究室(何鑫,姜珏)

收稿日期:2022-10-08 出版日期:2023-08-31 发布日期:2023-09-21
通讯作者: 姜珏,Email:jjyxy0414@163.com
基金资助:
陕西省社会发展项目(2018SF-084)

A novel treatment on small hepatocellular carcinoma adjacent to large vessels by ultrasound assisted precision microwave ablation

ZHANG Hai-rong¹, LI Jin-song¹, TIAN Xiu-li¹, HE Xin², JIANG Jue²

1. Department of Functional Section,Xi'an Gem Flower Changqing Hospital,Shaanxi 710020,China;
2. Ultrasonic Research Room , the Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi 710020,China

Received:2022-10-08 Online:2023-08-31 Published:2023-09-21
Contact: JIANG Jue,Email:jjyxy0414@163.com

摘要/Abstract

摘要： 目的观察超声新技术辅助大血管旁小肝癌精准微波消融治疗效果。方法选取西安宝石花长庆医院收治的大血管旁小肝癌患者76例,依据所选手术方式的不同分为对照组(手术切除治疗)36例和研究组(超声新技术辅助下的微波消融治疗)40例。对比两组患者手术时间、住院时间、并发症发生情况及术后1个月手术切除率。随访1年,对比两组患者术后1年肿瘤进展发生率及生存情况。结果研究组手术时间、住院时间均短于对照组分别为(92.45±15.28)min比(138.41±28.35)min、(6.12±1.47)d比(10.06±2.13)d(t=8.918、9.463,均P<0.05)。研究组住院期间并发症发生率低于对照组,2.78%(1/36)比17.50%(7/40)(χ²=4.360,P=0.037)。对照组、研究组病灶切除率为100%(36/36)比95%(38/40),差异无统计学意义(χ²=1.849,P=0.174)。对照组、研究组术后1年肿瘤进展发生率为16.67%(6/36)比17.50%(7/40),差异无统计意义(χ²=0.009,P=0.923)。对照组、研究组术后1年生存率为83.33%(30/36)比80.00%(32/40),差异无统计学意义(χ²=0.165,P=0.684)。结论超声新技术辅助大血管旁小肝癌精准微波消融治疗可达到与手术切除相同的治疗效果,但手术及住院时间较短,并发症相对较少。

关键词: 超声造影, 融合影像, 小肝癌, 微波消融

Abstract: Objective To observe the effect of a novel ultrasound technology assisted precise microwave ablation for small hepatocellular carcinoma adjacent to large vessels.Methods A total of 76 patients with small hepatocellular carcinoma near large blood vessels who were admitted to Xi'an Baoshihua Changqing Hospital were selected and divided into a control group (with surgical resection, n=36 cases) and a study group (with microwave ablation treatment assisted by new technology of ultrasound, n=40 cases) according to the different surgical regimes selected. The operation time, hospital stay, incidence of complications and 1month postoperative resection rate were compared between the two groups. The patients were followed up for 1 year, and the incidence of tumor progression and survival at 1 year after surgery were compared.Results The operation time and hospital stay in the study group were shorter than those of the control group [(92.45±15.28) min vs (138.41±28.35) min, and (6.12±1.47) d vs (10.06±2.13)d, respectively] (t=8.918, 9.463, all P<0.05). The incidence of complications during hospitalization in the study group (2.78% vs 17.50%) was lower (χ²=4.360, P=0.037). The surgical resection rates of the control group and the study group (2.78% vs 17.50%) were similar (χ²=1.849, P=0.174). The incidence of tumor progression at 1 year after operation in the control group and the study group was similar (16.67% vs 17.50%) (χ²=0.009, P=0.923). The 1-year survival rates of the control group and the study group were similar (83.33% vs 80.00%) (χ²=0.165, P=0.684).Conclusion The treatment of ultrasound technology assisted precise microwave ablation for small liver cancer adjacent to large vessels can achieve the same therapeutic effect as surgical resection, with shorter operation time and hospital stay, as well as relatively less complications.

Key words: Contrast-enhanced ultrasound, Fusion image, Small liver cancer, Microwave ablation

张海荣, 李劲松, 田秀丽, 何鑫, 姜珏. 超声新技术辅助大血管旁小肝癌精准微波消融治疗效果观察[J]. 肝脏, 2023, 28(8): 932-934.

ZHANG Hai-rong, LI Jin-song, TIAN Xiu-li, HE Xin, JIANG Jue. A novel treatment on small hepatocellular carcinoma adjacent to large vessels by ultrasound assisted precision microwave ablation[J]. Chinese Hepatolgy, 2023, 28(8): 932-934.

参考文献

[1] 刘若冰, 李开艳, 罗鸿昌, 等. 大血管旁部位小肝癌的精准消融治疗. 介入放射学杂志, 2019, 28(5):40-43.
[2] 母青林, 胡琼, 黄文光, 等. 钆贝葡胺MRI增强在肝硬化结节与小肝癌诊断鉴别中的应用. 中国CT和MRI杂志, 2020, 18(4):98-100.
[3] 苏少慧, 樊梅月, 陈伟华, 等. 临床实用肝脏病学. 石家庄: 河北科学技术出版社, 2011:35-38.
[4] Dumolard L, Ghelfi J, Roth G, et al. Percutaneous ablation-induced immunomodulation in hepatocellular carcinoma. Int J Mol Sci, 2020,21(12):48-51.
[5] Ni Y, Ye X, Yang X, et al. Microwave ablation for non-small cell lung cancer with synchronous solitary extracranial metastasis. J Cancer Res Clin Oncol, 2020,146(5):1361-1367.
[6] 刘若冰. 超声引导下经皮微波消融治疗大血管旁小肝癌的疗效和安全性研究. 武汉:华中科技大学, 2016.
[7] Wang Z, Tang X, Qi X, et al. Feasibility, safety, and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic hemangioma. Int J Hyperthermia, 2018,35(1):246-252.
[8] 王倩, 沈立新, 陈双和. 超声新技术辅助微波消融治疗特殊部位小肝癌的临床疗效. 浙江创伤外科, 2020, 25(1):103-105.
[9] Perrodin S, Lachenmayer A, Maurer M, et al. Percutaneous stereotactic image-guided microwave ablation for malignant liver lesions. Sci Rep, 2019,9(1):36-41.
[10] 王俊东, 魏达友, 吴绍锋, 等. 超声新技术辅助特殊部位小肝癌微波消融与手术切除的疗效对比研究. 中国超声医学杂志, 2019, 35(6):506-510.
[11] Shiina S, Sato K, Tateishi R, et al. Percutaneous ablation for hepatocellular carcinoma: comparison of various ablation techniques and surgery. Can J Gastroenterol Hepatol, 2018,8(11):47-49.
[12] An C, Li W Z, Huang Z M, et al. Small single perivascular hepatocellular carcinoma: comparisons of radiofrequency ablation and microwave ablation by using propensity score analysis. Eur Radiol, 2021,31(7):4764-4773.
[13] Lin Z Y, Fang Y, Chen J, et al. Feasibility and efficacy study of microwave ablation of recurrent small HCC guided by enhanced liver-specific magnetic resonance imaging contrast agent. Int J Hyperthermia, 2020,37(1):1330-1335.
[14] Cui R, Yu J, Gu Y, et al. Microwave ablation assisted by three-dimensional visualization system as local therapy for relapsed hepatoblastoma: a small pilot study. Abdom Radiol (NY), 2019,44(8):2909-2915.
[15] Li Z, Jiao D, Han X, et al. Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided microwave ablation in the treatment of small hepatocellular carcinoma. Cancer Imaging, 2020,20(1):13-16.
[16] Biondetti P, Fumarola E M, Ierardi A M, et al. Percutaneous US-guided MWA of small liver HCC: predictors of outcome and risk factors for complications from a single center experience. Med Oncol, 2020,37(5):39-42.
[17] Pusceddu C, Melis L, Ballicu N, et al. Percutaneous microwave ablation under CT guidance for hepatocellular carcinoma: a single institutional experience. J Gastrointest Cancer, 2018,49(3):295-301.