Livraghi T, Salmi A, Bolondi L, Marin G, Arienti V, Monti F, Vettori C
Servizio di Radiologia, Ospedale Civile, Vimercate, Milan, Italy.
Radiology. 1988 Aug;168(2):313-7. doi: 10.1148/radiology.168.2.2839865.
Twenty-three patients with hepatocellular carcinoma less than 4.5 cm in diameter (32 lesions) were treated with a percutaneous injection of ethyl alcohol performed with ultrasound (US) guidance. No complications or sequelae occurred after 271 treatments. All lesions were smaller after 6-27 months follow-up. No evidence of hepatocellular carcinoma was present at fine-needle biopsy or contrast material-enhanced computed tomography (CT). No viable tumor cells were detected in four patients who subsequently underwent surgery. The 1-year survival rate of 12 patients was 91.7%. From these data, it can be concluded that percutaneous alcohol injection (PAI) is an appropriate first-line treatment for patients with small hepatocellular carcinoma lesions who are poor surgical risks. Given the risk of new nodular lesions occurring on resected livers and the risk of perioperative mortality, PAI might even be considered an alternative to surgery.
23例直径小于4.5 cm的肝细胞癌患者（共32个病灶）接受了在超声（US）引导下经皮注射乙醇治疗。271次治疗后未出现并发症或后遗症。随访6 - 27个月后，所有病灶均缩小。细针活检或对比剂增强计算机断层扫描（CT）均未发现肝细胞癌迹象。4例随后接受手术的患者未检测到存活肿瘤细胞。12例患者的1年生存率为91.7%。从这些数据可以得出结论，经皮酒精注射（PAI）是手术风险高的小肝细胞癌病灶患者合适的一线治疗方法。鉴于切除肝脏上出现新结节性病灶的风险以及围手术期死亡率，PAI甚至可能被视为手术的替代方法。
