Alnaggar Mohammed, Niu Lizhi, Li Jialiang, Yao Fei, Wang Yuan, Zeng Jianying, Ye Jin, Chen Jibing, Mu Feng, Xu Kecheng
Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1277 of JieFang Road, Wuhan 430032, China.
Fuda Cancer Hospital, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510665, China; Fuda Institute of Cryosurgery for Cancer, No. 2 Tangdexi Road, Tianhe District, Guangzhou 510665, China.
Cryobiology. 2014 Dec;69(3):457-61. doi: 10.1016/j.cryobiol.2014.10.004. Epub 2014 Oct 14.
Percutaneous cryoablation is a potential cure for hepatocellular carcinoma (HCC). This study reviewed retrospectively clinical data from 14 patients who underwent cryoablation of huge HCC (long diameter >7 cm). The side effects of cryosurgeries and liver function reverse were recorded and compared everyday. All the patients survived cryosurgery and none died before leaving hospital 2 weeks later. Despite liver-protective treatment before cryosurgery, alanine transaminase (ALT) and aspartate transaminase (AST) levels were increased significantly, but returned to preoperative levels 2 weeks post-cryosurgery. Before cryosurgery, mean total bilirubin (T.BIL) and direct bilirubin (D.BIL) levels were normal; 8-10 days after cryosurgery, they increased more than two-fold, but returned to the preoperative level 2 weeks post-cryosurgery. Serum transaminase and bilirubin levels were compared between hepatitis B positive and negative patients. The hepatitis B negative group's AST level increased significantly 1 day post-cryosurgery (mean, 186 U/L) and decreased to the preoperative level at day 14. In the hepatitis B positive group, means transaminase and bilirubin reached peak values at different days post-cryosurgery. Overall, ALT and AST are valuable indicators of liver function impairment following cryosurgery. In patients with hepatitis B virus, close attention to the serum bilirubin level should be paid 8-10 days after cryosurgery. Liver-protective treatment may alleviate liver function impairment caused by cryosurgery of huge HCC.
经皮冷冻消融术是肝细胞癌（HCC）的一种潜在治疗方法。本研究回顾性分析了14例接受巨大肝癌（长径>7 cm）冷冻消融术患者的临床资料。每天记录并比较冷冻手术的副作用及肝功能恢复情况。所有患者均在冷冻手术后存活，2周后出院前无死亡病例。尽管在冷冻手术前进行了保肝治疗，但丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）水平仍显著升高，但在冷冻手术后2周恢复至术前水平。冷冻手术前，平均总胆红素（T.BIL）和直接胆红素（D.BIL）水平正常；冷冻手术后8 - 10天，它们升高了两倍多，但在冷冻手术后2周恢复至术前水平。比较了乙肝阳性和阴性患者的血清转氨酶和胆红素水平。乙肝阴性组在冷冻手术后1天AST水平显著升高（平均186 U/L），并在第14天降至术前水平。在乙肝阳性组中，转氨酶和胆红素的平均值在冷冻手术后不同时间达到峰值。总体而言，ALT和AST是冷冻手术后肝功能损害的重要指标。对于乙肝病毒感染患者，冷冻手术后8 - 10天应密切关注血清胆红素水平。保肝治疗可能减轻巨大肝癌冷冻手术引起的肝功能损害。
