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本文引用的文献

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A clinical study of thermal monitoring techniques of ultrasound-guided microwave ablation for hepatocellular carcinoma in high-risk locations.超声引导微波消融治疗高危部位肝癌的热监测技术的临床研究。
Sci Rep. 2017 Jan 23;7:41246. doi: 10.1038/srep41246.
2
Percutaneous cryoablation for hepatocellular carcinoma.经皮冷冻消融治疗肝细胞癌。
Clin Mol Hepatol. 2016 Dec;22(4):509-515. doi: 10.3350/cmh.2016.0079.
3
Cryoablation of Hepatocellular Carcinoma with High-Risk for Percutaneous Ablation: Safety and Efficacy.经皮消融高风险肝细胞癌的冷冻消融：安全性与有效性
Cardiovasc Intervent Radiol. 2016 Oct;39(10):1447-54. doi: 10.1007/s00270-016-1384-4. Epub 2016 Jun 2.
4
Modeling Cryotherapy Ice Ball Dimensions and Isotherms in a Novel Gel-based Model to Determine Optimal Cryo-needle Configurations and Settings for Potential Use in Clinical Practice.在一种新型凝胶模型中模拟冷冻疗法冰球尺寸和等温线，以确定在临床实践中可能使用的最佳冷冻针配置和设置。
Urology. 2016 May;91:234-40. doi: 10.1016/j.urology.2016.02.012. Epub 2016 Feb 20.
5
Insufficient ablative margin determined by early computed tomography may predict the recurrence of hepatocellular carcinoma after radiofrequency ablation.早期计算机断层扫描所确定的消融边缘不足可能预示着肝细胞癌射频消融术后的复发。
Liver Cancer. 2015 Mar;4(1):26-38. doi: 10.1159/000343877.
6
Angiotensin receptor blockers improve survival outcomes after radiofrequency ablation in hepatocarcinoma patients.血管紧张素受体阻滞剂可改善肝癌患者射频消融术后的生存结局。
J Gastroenterol Hepatol. 2015 Nov;30(11):1643-50. doi: 10.1111/jgh.12988.
7
Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria.米兰标准内肝细胞癌患者经皮冷冻消融的长期疗效
PLoS One. 2015 Apr 7;10(4):e0123065. doi: 10.1371/journal.pone.0123065. eCollection 2015.
8
Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma.多中心随机对照临床试验：经皮冷冻消融与射频消融治疗肝细胞癌的比较。
Hepatology. 2015 May;61(5):1579-90. doi: 10.1002/hep.27548. Epub 2015 Mar 20.
9
Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation.经皮射频消融术后肝细胞癌复发后的生存情况
Dig Liver Dis. 2014 Nov;46(11):1014-9. doi: 10.1016/j.dld.2014.07.012. Epub 2014 Jul 29.
10
Alleviating the pain of unresectable hepatic tumors by percutaneous cryoablation: experience in 73 patients.经皮冷冻消融治疗不可切除肝肿瘤的疼痛缓解：73 例患者的经验。
Cryobiology. 2013 Dec;67(3):369-73.

经皮冷冻消融治疗早期肝细胞癌：局部肿瘤进展因素分析。

Percutaneous cryoablation in early stage hepatocellular carcinoma: analysis of local tumor progression factors.

机构信息

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University School of Medicine, Seoul, Korea.

出版信息

Diagn Interv Radiol. 2020 Mar;26(2):111-117. doi: 10.5152/dir.2019.19246.

DOI:10.5152/dir.2019.19246
PMID:32071029
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7051268/
Abstract

PURPOSE

We aimed to evaluate the effectiveness and safety of percutaneous cryoablation (PC) for early or very early stage hepatocellular carcinoma (HCC) and assess the risk factors for local tumor progression (LTP) after PC.

METHODS

A total of 45 treatment-naïve patients treated with PC for early or very early stage HCCs were included in this retrospective study. The safety of PC was assessed by evaluating procedure-related complications and comparing hepatic function before and after the procedure. The effectiveness was assessed by evaluating technical success, LTP rates, and disease progression (DP) rates. Prognostic factors associated with LTP after PC were also analyzed.

RESULTS

Technical success and complete response were achieved in all patients (100%) by 1 month after PC. During a mean of 28.1±15.6 months of follow-up, the incidences of LTP and DP were 11.1% and 37.8%, respectively. The LTP-free and DP-free survival rates were 93.3% and 84.4% at 1 year and 88.9% and 62.2% at 2 years, respectively. Hepatic function was normalized within 3 months after PC. There were no major complications and only one minor complication of small hematoma. On univariate and multivariate analysis, minimal ablative margin <5 mm was the only significant risk factor associated with LTP.

CONCLUSION

PC is a safe and effective therapy for patients with early or very early stage HCC. Minimal ablative margin <5 mm was a significant prognostic factor for LTP.

摘要

目的

本研究旨在评估经皮冷冻消融（PC）治疗早期或极早期肝细胞癌（HCC）的有效性和安全性，并评估 PC 后局部肿瘤进展（LTP）的危险因素。

方法

本回顾性研究共纳入 45 例接受 PC 治疗的早期或极早期 HCC 初治患者。通过评估与操作相关的并发症和比较操作前后的肝功能来评估 PC 的安全性。通过评估技术成功率、LTP 发生率和疾病进展（DP）率来评估有效性。还分析了与 PC 后 LTP 相关的预后因素。

结果

所有患者（100%）在 PC 后 1 个月均达到技术成功和完全缓解。在平均 28.1±15.6 个月的随访中，LTP 和 DP 的发生率分别为 11.1%和 37.8%。1 年时 LTP 无进展和 DP 无进展生存率分别为 93.3%和 84.4%，2 年时分别为 88.9%和 62.2%。PC 后 3 个月内肝功能恢复正常。无重大并发症，仅 1 例出现小血肿的轻微并发症。单因素和多因素分析显示，最小消融边界<5mm 是与 LTP 相关的唯一显著危险因素。

结论

PC 是治疗早期或极早期 HCC 患者的一种安全有效的治疗方法。最小消融边界<5mm 是 LTP 的一个显著预后因素。