Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan.
J Vasc Interv Radiol. 2010 Feb;21(2):237-44. doi: 10.1016/j.jvir.2009.10.015. Epub 2010 Jan 14.
To prospectively evaluate the occurrence of a 'popping' sound during radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) and its association with early tumor progression and patient survival.
Seventy-six patients with 100 tumors underwent RF ablation by using an internally cooled electrode. A popping sound was defined as an audible sound or tactile vibration detected by the operator during RF ablation. Follow-up ranged from 6 to 38 months (mean, 19 months) and included 3-6 month ultrasonography, serum alpha-fetoprotein measurements, and computed tomography or magnetic resonance imaging. Early local and distant intrahepatic tumor progression within 12 months and survival were analyzed.
A popping sound occurred during 58 of the 100 (58%) tumor ablations. Primary technique effectiveness was achieved in 97 of the 100 (97%) tumors. Major complications occurred in 2 of the 76 patients (2.6%). The cumulative rate of early local tumor progression was 20.8%. At multivariate analysis, early local tumor progression was associated with tumor size larger than 3 cm (odds ratio [OR] = 4.08, P = .012) and inversely associated with a popping sound (OR = 0.267, P = .026). The cumulative rate of early distant intrahepatic tumor progression was 21.4%, and the cumulative survival of the whole cohort at 6, 12, 18, and 24 months was 98.7%, 96%, 92.7%, and 83.6%, respectively. A popping sound was not significantly associated with either early distant intrahepatic tumor progression (P = .341) or patient survival (P = .975).
A popping sound during RF ablation is not associated with an increased risk of early tumor progression or poorer patient survival.
前瞻性评估肝癌射频消融（RF）过程中“噼啪”声的发生情况及其与早期肿瘤进展和患者生存的关系。
76 例 100 个肿瘤患者接受了内置冷却电极的 RF 消融治疗。操作人员在 RF 消融过程中检测到的可听声音或触觉振动被定义为“噼啪”声。随访时间为 6 至 38 个月（平均 19 个月），包括 3-6 个月的超声检查、血清甲胎蛋白测量以及计算机断层扫描或磁共振成像。分析了 12 个月内早期局部和远处肝内肿瘤进展以及生存情况。
100 个肿瘤中有 58 个（58%）在消融过程中出现了“噼啪”声。100 个肿瘤中有 97 个（97%）达到了主要技术效果。76 例患者中有 2 例（2.6%）发生了重大并发症。早期局部肿瘤进展的累积发生率为 20.8%。多变量分析显示，早期局部肿瘤进展与肿瘤直径大于 3cm 相关（比值比[OR] = 4.08，P =.012），与“噼啪”声呈负相关（OR = 0.267，P =.026）。早期远处肝内肿瘤进展的累积发生率为 21.4%，整个队列的 6、12、18 和 24 个月累积生存率分别为 98.7%、96%、92.7%和 83.6%。“噼啪”声与早期远处肝内肿瘤进展（P =.341）或患者生存（P =.975）均无显著相关性。
RF 消融过程中的“噼啪”声与早期肿瘤进展风险增加或患者生存状况恶化无关。
