Department of Gastroenterology, Faculty of Medicine, Kanto Central Hospital, 6-25-1 Kamiyoga, Setagaya-ku, Tokyo, 158-8531, Japan,
Hepatol Int. 2007 Jun;1(2):295-301. doi: 10.1007/s12072-007-9001-x.
BACKGROUND/AIMS: Percutaneous tumor ablation (PTA), such as ethanol injection, is currently accepted as a potentially curative treatment for hepatocellular carcinoma (HCC). Percutaneous tumor ablation is presumed to be relatively non-invasive, but there are few studies on long-term follow-up of liver function after tumor ablation.
Changes in liver functions were monitored in 227 consecutive patients treated for a solitary HCC nodule by PTA between 1993 and 1997. The liver function evaluated based on Child-Turcotte classification prior to the initial treatment was Child A in 119 (52.4%) patients, B in 81(35.7%), and C in 27 (11.9%). The follow-up period was 46 +/- 21 months.
The five-year survival rates of patients in Child A, B, and C group after treatment were respectively 76%, 45%, and 43%. Annual shift rate of Child A to Child B was 7%, and that of Child B to Child C was 14%. Tumor recurrence significantly affected aggravation of liver function in Child A (P = 0.002) but not in Child B patients (P = 0.55). Tumor size at initial treatment influenced changes of liver function in Child B group patients (P = 0.009).
Preservation of liver function may be essential when treating HCC patients with impaired liver function.
背景/目的：经皮肿瘤消融（PTA），如乙醇注射，目前被认为是治疗肝细胞癌（HCC）的一种潜在根治性治疗方法。PTA 被认为是相对非侵入性的，但关于肿瘤消融后肝功能的长期随访研究较少。
1993 年至 1997 年间，对 227 例接受单一 HCC 结节 PTA 治疗的连续患者进行了肝功能监测。根据初始治疗前的 Child-Turcotte 分级评估的肝功能，A 级 119 例（52.4%），B 级 81 例（35.7%），C 级 27 例（11.9%）。随访时间为 46 +/- 21 个月。
治疗后 A、B 和 C 组患者的五年生存率分别为 76%、45%和 43%。A 组 Child A 转为 Child B 的年转化率为 7%，B 组 Child B 转为 Child C 的年转化率为 14%。肿瘤复发显著影响 A 组 Child A 肝功能的恶化（P = 0.002），但对 B 组患者无影响（P = 0.55）。初始治疗时肿瘤大小影响 B 组患者肝功能的变化（P = 0.009）。
在治疗肝功能受损的 HCC 患者时，保持肝功能可能至关重要。
