Deng Han-Xia, Huang Jin-Hua, Lau Wan Yee, Ai Fei, Chen Min-Shan, Huang Zhi-Mei, Zhang Tian-Qi, Zuo Meng-Xuan
Department of Minimally Invasive Interventional Therapy, Cancer Centre of Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Department of Hepatobiliary Surgery, Cancer Centre of Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
World J Clin Cases. 2019 Feb 26;7(4):508-515. doi: 10.12998/wjcc.v7.i4.508.
To report on the use of percutaneous hydrochloric acid (HCl) enhanced radiofrequency ablation (HRFA) for the treatment of large (maximum diameter ≥ 5 cm) hepatocellular carcinoma (HCC) in the caudate lobe.
Between August 2013 and June 2016, three patients with a large HCC (maximum diameter: 5.0, 5.7, and 8.1 cm) in the caudate lobe were treated by transarterial chemoembolization followed by computer tomography (CT) guided RFA using a monopolar perfusion RF electrode, which was enhanced by local infusion of 10% HCl at 0.2 mL/min (total volume, 3 to 12 mL). The output power of HRFA reached 100 W, and the average ablation time was 39 min (range, 15 to 60 min). Two patients each underwent one session of HRFA and one patient two sessions. After treatment, CT/magnetic resonance imaging showed that all the three lesions were completely ablated. There was no major complication. Two patients had asymptomatic bile duct dilatation. One patient died of tongue cancer 24 mo after ablation. The remaining two patients were alive and no area of enhancement is detected in the caudate lobe at 28 and 60 mo after ablation, respectively.
Percutaneous CT-guided HRFA is safe and efficacious in treating large HCC in the caudate lobe.
报道经皮盐酸增强射频消融术（HRFA）治疗尾状叶大（最大直径≥5 cm）肝细胞癌（HCC）的应用情况。
2013年8月至2016年6月，3例尾状叶大肝癌（最大直径分别为5.0、5.7和8.1 cm）患者先接受经动脉化疗栓塞，然后采用单极灌注射频电极在计算机断层扫描（CT）引导下进行射频消融（RFA），通过以0.2 mL/min的速度局部注入10%盐酸（总量3至12 mL）增强消融效果。HRFA的输出功率达到100 W，平均消融时间为39分钟（范围15至60分钟）。2例患者各接受1次HRFA治疗，1例患者接受2次治疗。治疗后，CT/磁共振成像显示3个病灶均完全消融。无严重并发症发生。2例患者出现无症状胆管扩张。1例患者在消融后24个月死于舌癌。其余2例患者存活，分别在消融后28个月和60个月时尾状叶未检测到强化区域。
经皮CT引导下的HRFA治疗尾状叶大肝癌安全有效。
