Dong Baowei, Liang Ping, Yu Xiaoling, Su Li, Yu Dejiang, Zhang Jing, Wen Chaoyang
Department of Ultrasound, PLA General Hospital, Beijing 100853, China.
Zhonghua Zhong Liu Za Zhi. 2002 May;24(3):282-4.
To evaluate the long-term results of percutaneous microwave coagulation therapy (PMCT) for primary hepatocellular carcinoma.
From May 1994 to May 2000, 177 hepatocellular carcinoma patients with 265 nodules underwent PMCT with ultrasound (US) guidance. The tumor size varied from 1.5 to 8.7 cm (median 4.12 + 1.9 cm). Follow-up examination was carried out with colour US, CT, MRI and AFP. 184 nodules were re-biopsied during the follow up of 5 - 74 months (median 29 months).
After PMCT, colour Doppler flow signals disappeared in 92.0% (207/225) of patients. No enhancement was observed in 88.5% (138/156) by CT and 88.9% (32/36) by MRI. Re-biopsy of 184 nodules showed complete necrosis in 92.4% (170/184). Six resected lesions showed complete tumor necrosis in 5 and subtotal necrosis in 1. The 1- to 5-year survival rates were 90.1%, 76.9%, 68.3%, 64.2% and 57.8%, respectively. The survival rates of the well differentiated lesions were better than those of the poorly ones (P < 0.05). But there was not statistical significance between the moderately and the well differentiated ones. The new lesions development rates in 1 to 5 years were 26.1%, 37.8%, 43.5%, 48.6% and 58.9%, respectively. However, there was no severe complication.
Ultrasound-guided microwave coagulation is safe and effective for primary hepatocellular carcinoma. It can eliminate tumors less than 5 cm in diameter.
评估经皮微波凝固治疗（PMCT）原发性肝细胞癌的长期疗效。
1994年5月至2000年5月，177例肝细胞癌患者的265个结节在超声（US）引导下接受了PMCT治疗。肿瘤大小从1.5厘米至8.7厘米不等（中位数为4.12 + 1.9厘米）。采用彩色超声、CT、MRI和甲胎蛋白进行随访检查。在5至74个月（中位数为29个月）的随访期间，对184个结节进行了再次活检。
PMCT治疗后，92.0%（207/225）的患者彩色多普勒血流信号消失。CT检查显示88.5%（138/156）无强化，MRI检查显示88.9%（32/36）无强化。对184个结节的再次活检显示92.4%（170/184）完全坏死。6个切除的病灶中，5个显示肿瘤完全坏死，1个显示次全坏死。1至5年生存率分别为90.1%、76.9%、68.3%、64.2%和57.8%。高分化病灶的生存率优于低分化病灶（P < 0.05）。但中分化和高分化病灶之间无统计学意义。1至5年新病灶发生率分别为26.1%、37.8%、43.5%、48.6%和58.9%。然而，未出现严重并发症。
超声引导下微波凝固治疗原发性肝细胞癌安全有效。它可消除直径小于5厘米的肿瘤。
