超声引导与CT引导下射频消融治疗对原发性肝细胞癌患者肝功能、血清异常凝血酶原-II、甲胎蛋白水平及复发情况的比较
Comparison of ultrasound guided versus CT guided radiofrequency ablation on liver function, serum PIVKA-II, AFP levels and recurrence in patients with primary hepatocellular carcinoma.
作者信息
Yu Zusheng, Li Guowei, Yuan Nianyong, Ding Wei
机构信息
Department of Hepatobiliary Surgery, The First People's Hospital of Fuyang Hangzhou Hangzhou 311400, Zhejiang, China.
出版信息
Am J Transl Res. 2021 Jun 15;13(6):6881-6888. eCollection 2021.
OBJECTIVE
This study aimed to compare the effects of ultrasound and CT-guided radiofrequency ablation (RFA) on liver function, serum antagonist-II (PIVKA-II), alpha-fetoprotein (AFP) levels, and disease recurrence in patients with primary hepatocellular carcinoma (PHC).
METHODS
Ninety-eight patients with PHC were enrolled and treated with RFA. They were grouped as the ultrasound-guided group (n=51) and the CT-guided group (n=47) according to the specific guidance methods. The clinical efficacy, recurrence and survival after treatment, as well as the changes of liver function, serum PIVKA-II and AFP levels before and after treatment were compared between the two groups.
RESULTS
The total effective rate of the CT-guided group (87.23%) was significantly higher than that of the ultrasound-guided group (62.75%) ( < 0.05). Total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were reduced in both groups after treatment ( < 0.05) and were lower in the CT-guided group than in the ultrasound-guided group ( < 0.05). Albumin (ALB) levels were elevated in both groups after treatment ( < 0.05) and were higher in the CT-guided group than in the ultrasound-guided group ( < 0.05). PIVKA-II and AFP levels decreased in both groups after treatment ( < 0.05) and were significantly lower in the CT-guided group than in the ultrasound-guided group ( < 0.05). The 2-year and 3-year recurrence rates in the CT-guided group were 4.26% and 8.51%, respectively, significantly lower than 17.65% and 27.45% in the ultrasound-guided group ( < 0.05), and the 2-year and 3-year survival rates in the CT-guided group were 89.36% and 72.34%, respectively, significantly higher than 72.55% and 50.98% in the ultrasound-guided group ( < 0.05).
CONCLUSION
Compared with ultrasound guidance, CT-guided RFA can more effectively improve liver function, reduce serum IVKA-II and AFP levels, reduce recurrence rate, and improve survival time in the treatment of PHC.
目的
本研究旨在比较超声引导和CT引导下射频消融（RFA）对原发性肝细胞癌（PHC）患者肝功能、血清异常凝血酶原（PIVKA-II）、甲胎蛋白（AFP）水平及疾病复发的影响。
方法
纳入98例PHC患者并接受RFA治疗。根据具体引导方法将其分为超声引导组（n = 51）和CT引导组（n = 47）。比较两组治疗后的临床疗效、复发及生存情况，以及治疗前后肝功能、血清PIVKA-II和AFP水平的变化。
结果
CT引导组的总有效率（87.23%）显著高于超声引导组（62.75%）（P < 0.05）。两组治疗后总胆红素（TBIL）、直接胆红素（DBIL）、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）均降低（P < 0.05），且CT引导组低于超声引导组（P < 0.05）。两组治疗后白蛋白（ALB）水平均升高（P < 0.05），且CT引导组高于超声引导组（P < 0.05）。两组治疗后PIVKA-II和AFP水平均降低（P < 0.05），且CT引导组显著低于超声引导组（P < 0.05）。CT引导组的2年和3年复发率分别为4.26%和8.51%，显著低于超声引导组的17.65%和27.45%（P < 0.05），CT引导组的2年和3年生存率分别为89.36%和72.34%，显著高于超声引导组的72.55%和50.98%（P < 0.05）。
结论
与超声引导相比，CT引导下RFA在治疗PHC时能更有效地改善肝功能，降低血清IVKA-II和AFP水平，降低复发率，提高生存时间。
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