Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Korea.
Clin Mol Hepatol. 2012 Sep;18(3):302-8. doi: 10.3350/cmh.2012.18.3.302. Epub 2012 Sep 25.
BACKGROUND/AIMS: We evaluated changes in liver function parameters and risk factors for the deterioration of liver function 12 months after percutaneous radiofrequency ablation (RFA) therapy in patients with hepatocellular carcinoma (HCC).
The subjects in this retrospective study comprised 102 patients with HCC who had undergone RFA therapy and exhibited no recurrence of HCC 12 months thereafter. Serial changes in serum total bilirubin and albumin, prothrombin time, and Child-Pugh score were evaluated before RFA and 3, 6, 9, and 12 months thereafter. Deterioration of liver function was defined when the Child-Pugh score increased by at least 2 at 12 months after RFA therapy. We determined the factors related to aggravation of liver function after RFA therapy.
Liver function had deteriorated 12 months after RFA in 29 patients (28.4%). Serum albumin levels decreased significantly from before (3.7±0.1 g/dL, mean±SD) to 12 months after RFA therapy (3.3±0.1 g/dL, P=0.002). The Child-Pugh score increased significantly during the same time period (from 6.1±0.2 to 7.2±0.3, P<0.001). Pre-RFA thrombocytopenia (≤100,000/mm(3)) was revealed as a significant risk factor for the deterioration of liver function after RFA. However, no patients had episodes of bleeding as a complication of RFA.
Among the liver-function parameters, serum albumin level was markedly decreased in HCC patients over the course of 24 months after RFA therapy. A pre-RFA thrombocytopenia represents a major risk factor for the deterioration of liver function.
背景/目的:我们评估了肝癌患者经皮射频消融(RFA)治疗 12 个月后肝功能参数的变化和肝功能恶化的危险因素。
本回顾性研究的对象为 102 例经 RFA 治疗且 12 个月后无 HCC 复发的 HCC 患者。在 RFA 治疗前和治疗后 3、6、9 和 12 个月评估血清总胆红素和白蛋白、凝血酶原时间和 Child-Pugh 评分的变化。当 RFA 治疗后 12 个月 Child-Pugh 评分增加至少 2 分时,定义肝功能恶化。我们确定了与 RFA 治疗后肝功能恶化相关的因素。
29 例(28.4%)患者在 RFA 治疗 12 个月后肝功能恶化。血清白蛋白水平从 RFA 治疗前(3.7±0.1 g/dL,平均值±标准差)显著下降至治疗后 12 个月(3.3±0.1 g/dL,P=0.002)。同期 Child-Pugh 评分显著增加(从 6.1±0.2 增加至 7.2±0.3,P<0.001)。RFA 前血小板减少症(≤100,000/mm³)是 RFA 后肝功能恶化的显著危险因素。然而,没有患者因 RFA 而发生出血并发症。
在 RFA 治疗后 24 个月内,肝癌患者的肝功能参数中血清白蛋白水平显著下降。RFA 前血小板减少症是肝功能恶化的主要危险因素。