Ohnishi K, Ohyama N, Ito S, Fujiwara K
Third Department of Medicine, Saitama Medical School, Japan.
Radiology. 1994 Dec;193(3):747-52. doi: 10.1148/radiology.193.3.7972818.
To assess the efficacy of ultrasound-guided percutaneous acetic acid injection (PAI) in the treatment of hepatocellular carcinoma (HCC).
Results of a preliminary study in rats showed that the effectiveness of acetic acid in the destruction of hepatocytes plateaued at a concentration of 50%. Thus, PAI with 50% acetic acid was performed in 25 patients with solitary HCCs 3 cm or less in diameter. The viability of tumor cells after PAI was examined by means of contrast material-enhanced computed tomography (CT) and fine-needle biopsy in all patients. Two patients underwent partial hepatic resection.
No clinically significant complications occurred in 82 treatment sessions. All lesions became smaller after a mean of 23 months +/- 8 (standard deviation) of follow-up. There was no evidence of viable HCC at follow-up biopsy and CT. Two HCCs obtained by means of resection showed complete necrosis. The 1-year survival rate among 23 patients who did not undergo surgical treatment was 100%; the 2-year survival rate was 92%.
PAI may prove to be an effective therapy for small HCC.
评估超声引导下经皮醋酸注射（PAI）治疗肝细胞癌（HCC）的疗效。
一项大鼠初步研究结果显示，醋酸破坏肝细胞的有效性在浓度为50%时达到平台期。因此，对25例直径3 cm或更小的孤立性HCC患者进行了50%醋酸PAI治疗。所有患者均通过对比剂增强计算机断层扫描（CT）和细针活检检查PAI后肿瘤细胞的活力。2例患者接受了肝部分切除术。
82次治疗过程中未发生具有临床意义的并发症。平均随访23个月±8（标准差）后，所有病灶均缩小。随访活检和CT检查均未发现存活的HCC证据。通过切除获得的2个HCC显示完全坏死。23例未接受手术治疗的患者1年生存率为100%；2年生存率为92%。
PAI可能是治疗小HCC的有效方法。
