经皮乙酸注射与经皮乙醇注射治疗小肝细胞癌的比较

Comparison of percutaneous acetic acid injection and percutaneous ethanol injection for small hepatocellular carcinoma.

作者信息

Ohnishi K

机构信息

Third Department of Medicine, Saitama Medical School, Japan.

出版信息

Hepatogastroenterology. 1998 Aug;45 Suppl 3:1254-8.

PMID:9730384

Abstract

BACKGROUND/AIMS: To assess whether ultrasound (US)-guided percutaneous acetic acid injection is more effective than percutaneous ethanol injection in the treatment of small hepatocellular carcinoma (HCC).

METHODOLOGY

sixty patients with 1 to 4 HCC smaller than 3 cm entered a randomized controlled trial from August 1993 to September 1995. Thirty one and 29 patients were treated by percutaneous acetic acid injection using 50% acetic acid and percutaneous ethanol injection using absolute ethanol, respectively. There were no significant differences in clinical characteristics and biochemical data between the two groups.

RESULTS

All original tumors were treated successfully by the chosen therapy. However, local recurrence occurred in 8% of the 38 tumors treated with percutaneous acetic acid injection and 37% of the 35 tumors treated with percutaneous ethanol injection P>0.001). The 1- and 2-year survival rates were 100% and 92% with percutaneous acetic acid injection and 83% and 63% with percutaneous ethanol injection (p=0.0017). Multivariate analysis of prognostic factors revealed that treatment was an independent predictor of survival.

CONCLUSION

percutaneous acetic acid injection is more effective than percutaneous ethanol injection.

摘要

背景/目的：评估超声引导下经皮醋酸注射在治疗小肝细胞癌（HCC）方面是否比经皮乙醇注射更有效。

方法

1993年8月至1995年9月，60例患有1至4个直径小于3厘米的HCC患者进入一项随机对照试验。分别有31例和29例患者接受了使用50%醋酸的经皮醋酸注射和使用无水乙醇的经皮乙醇注射治疗。两组患者的临床特征和生化数据无显著差异。

结果

所有原发性肿瘤均通过所选治疗方法成功治疗。然而，经皮醋酸注射治疗的38个肿瘤中有8%发生局部复发，经皮乙醇注射治疗的35个肿瘤中有37%发生局部复发（P>0.001）。经皮醋酸注射的1年和2年生存率分别为100%和92%，经皮乙醇注射的分别为83%和63%（P=0.0017）。对预后因素的多变量分析显示，治疗是生存的独立预测因素。