Li Meng, Li Zhiyan, Yu Xiaoling, Liang Ping, Gao Yuejuan, Han Zhiyu, Liu Fangyi, Dong Jinghui
a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China ;
b Department of Ultrasound , Beijing 302 Hospital , Beijing , China ;
Int J Hyperthermia. 2016 Sep;32(6):600-6. doi: 10.3109/02656736.2016.1157904. Epub 2016 Apr 25.
The purpose of the study was to prospectively evaluate the safety and the efficacy of percutaneous radio-frequency ablation of hepatocellular carcinoma adjacent to the gastrointestinal tract.
From April 2012 to November 2015, 141 hepatocellular carcinoma nodules that underwent ultrasound-guided percutaneous radio-frequency ablation were included. A total of 52 lesions were located less than 5 mm from the gastrointestinal tract in the study group, and 89 lesions were located more than 5 mm from hepatic surface in the control group. Ethanol (2.5-9.6 mL) was injected into marginal tissue of tumour in five lesions of the study group. During the ablation, the temperature of marginal ablation tissue proximal to the gastrointestinal tract was monitored and controlled at 45-56 °C for more than 10 min in the study group. We compared the results of ablation between the two groups.
In total 48 of 52 tumours (92.3%) in the study group and 84 of 89 tumours (94.4%) in the control group achieved complete ablation (P = 0.63). Local tumour progression was found in eight tumours (15.4%) in the study group and 11 tumours (12.4%) in the control group during follow-up (P = 0.61). There were neither immediate nor peri-procedural major complications in both groups, grade I (Clavien-Dindo classification). One case developed biloma at 5-month follow-up in the study group, Clavien-Dindo gradeIII.
Percutaneous radio-frequency ablation is safe and achieves a high complete ablation rate for the treatment of hepatocellular carcinoma adjacent to the gastrointestinal tract.
本研究旨在前瞻性评估经皮射频消融治疗胃肠道旁肝细胞癌的安全性和有效性。
纳入2012年4月至2015年11月期间接受超声引导下经皮射频消融的141个肝细胞癌结节。研究组中共有52个病灶距离胃肠道小于5毫米，对照组中有89个病灶距离肝表面大于5毫米。研究组的5个病灶向肿瘤边缘组织注射乙醇（2.5 - 9.6毫升）。在消融过程中，研究组对靠近胃肠道的消融边缘组织温度进行监测，并在45 - 56℃控制超过10分钟。我们比较了两组的消融结果。
研究组52个肿瘤中有48个（92.3%）、对照组89个肿瘤中有84个（94.4%）实现完全消融（P = 0.63）。随访期间，研究组有8个肿瘤（15.4%）、对照组有11个肿瘤（12.4%）出现局部肿瘤进展（P = 0.61）。两组均无即刻或围手术期严重并发症，均为I级（Clavien-Dindo分类）。研究组1例在5个月随访时发生胆汁瘤，Clavien-Dindo III级。
经皮射频消融治疗胃肠道旁肝细胞癌安全且完全消融率高。
