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不可逆电穿孔治疗的患者肝脏肿瘤消融区域的退缩速度快于微波消融。

Ablation Zone Involution of Liver Tumors Is Faster in Patients Treated with Irreversible Electroporation Than Microwave Ablation.

机构信息

Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.

Department of Interventional Radiology and Oncology, Tenon Hospital, Sorbonne University, 4 Rue de la Chine, 75020 Paris, France.

出版信息

Medicina (Kaunas). 2021 Aug 26;57(9):877. doi: 10.3390/medicina57090877.

Abstract

: To compare ablation zone involution following microwave ablation (MWA) or irreversible electroporation (IRE) of liver tumors. : MWA or IRE performed for colorectal cancer liver metastasis (CRLM) or hepatocellular carcinoma (HCC) during January 2011 to December 2015 were analyzed. Patients with a tumoral response on 1-year follow-up computed tomography (CT) were included. Generalized estimating equations were used to evaluate the differences between the two modalities on ablation zone involution observed on CT at 6 (M6) and 12 months (M12), and on laboratory values (total bilirubin, alanine transaminase, aspartate transaminase, alkaline phosphatase, albumin, and platelets count). The likelihood ratio test was used to assess whether the association between ablation modalities and these outcomes differed over time. : Seventeen (17/44, 39%) women and 27 (27/44, 61%) men were included, with 25 HCC (25/44, 57%) and 19 CRLM (19/44, 43%) patients. IRE was used in 9 (9/19, 47%) CRLM and 5 (5/25, 20%) HCC patients, respectively. All other patients had MWA. Ablation zone size and involution between IRE and MWA differed significantly over time (interaction < 0.01), with a mean of 241.04 vs. 771.08 mm (ratio 0.313; 95% CI, 0.165-0.592; < 0.01) at M6 and 60.47 vs. 589.43 mm (ratio 0.103; 95% CI, 0.029-0.365; < 0.01) at M12. Changes in liver enzymes did not differ significantly between IRE and MWA at both timepoints. : Liver tumors treated with IRE underwent faster involution when compared to tumors treated with MWA, but liver enzymes levels were comparable.

摘要

比较微波消融(MWA)或不可逆电穿孔(IRE)治疗肝肿瘤后的消融区域退缩情况。

对 2011 年 1 月至 2015 年 12 月期间因结直肠癌肝转移(CRLM)或肝细胞癌(HCC)而行 MWA 或 IRE 的患者进行分析。将在 1 年随访 CT 上有肿瘤反应的患者纳入研究。采用广义估计方程评估两种方法在 CT 上观察到的 6 个月(M6)和 12 个月(M12)消融区域退缩、实验室值(总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶、白蛋白和血小板计数)的差异。似然比检验用于评估消融方式与这些结果之间的关联是否随时间而变化。

共纳入 17 名女性(17/44,39%)和 27 名男性(27/44,61%),其中 25 名 HCC(25/44,57%)和 19 名 CRLM(19/44,43%)患者。IRE 分别用于 9 名(9/19,47%)CRLM 和 5 名(5/25,20%)HCC 患者,其余所有患者均接受 MWA 治疗。IRE 和 MWA 之间的消融区域大小和退缩在时间上差异有统计学意义(交互作用 < 0.01),M6 时的平均消融区域大小分别为 241.04mm 和 771.08mm(比值 0.313;95%CI,0.165-0.592; < 0.01),M12 时分别为 60.47mm 和 589.43mm(比值 0.103;95%CI,0.029-0.365; < 0.01)。在这两个时间点,IRE 和 MWA 之间的肝酶变化无显著差异。

与 MWA 治疗的肿瘤相比,IRE 治疗的肝肿瘤退缩更快,但肝酶水平相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2601/8467214/f55c780e4be7/medicina-57-00877-g001.jpg

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