超声引导下纳米刀消融治疗肝细胞癌患者效果分析*

doi:10.3969/j.issn.1672-5069.2026.03.026

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 421-424.doi: 10.3969/j.issn.1672-5069.2026.03.026

超声引导下纳米刀消融治疗肝细胞癌患者效果分析^*

郝秀秀, 张朝赫, 武翀, 靳福全, 张伟, 周婕, 查润民, 张一峰, 韩治宇, 周赟

100071 北京市解放军总医院第五医学中心超声诊断科(郝秀秀);介入超声科(张朝赫,武翀,靳福全,韩治宇);重庆市开州区人民医院胸心外科(周赟);重庆医科大学附属第二医院超声诊断(张伟,周婕,查润民);上海市第十人民医院超声医学科(张一峰)

收稿日期:2025-12-04 出版日期:2026-05-10 发布日期:2026-05-18
通讯作者: 周赟,E-mail:15310099564@163.com
作者简介:郝秀秀,女,41岁,医学硕士,副主任医师。E-mail:18500365025@163.com
基金资助:
^*国家重点研发计划项目(编号:2022YFF0606304)

Nanoknife irreversible electroporation under ultrasound guidance in the treatment of patients with unresectable hepatocellular carcinoma

Hao Xiuxiu, Zhang Chaohe, Wu Chong, et al

Department of Ultrasonography, Fifth Medical Center, General Hospital, People's Liberation Army, Beijing 100071, China

Received:2025-12-04 Online:2026-05-10 Published:2026-05-18

摘要/Abstract

摘要： 目的探讨纳米刀消融治疗肝细胞癌(HCC)患者的临床效果及安全性。方法 2021年1月～2024年12月我院收治的HCC患者102例,被分为两组,每组51例。给予观察组在超声引导下行纳米刀消融治疗,在对照组行射频消融治疗。常规检测血清甲胎蛋白(AFP)水平,使用流式细胞仪检测外周血淋巴细胞亚群。结果观察组客观缓解率(ORR)和疾病控制率(DCR)分别为64.7%和84.3%,均显著高于对照组(分别为41.2%和64.7%,P＜0.05);在术后1个月后,观察组血清AFP水平为(96.3±9.6)ng/mL,显著低于对照组【(218.7±12.5)ng/mL,P＜0.05】;观察组外周血CD3⁺、CD4⁺细胞百分比和CD4⁺/CD8⁺细胞比值分别为(71.5±9.1)%、(40.7±6.5)%和(1.8±0.4),均显著高于对照组【分别为(62.4±8.8)%、(36.8±7.0)%和(1.4±0.3),P＜0.05】,而CD8⁺细胞百分比为(22.1±5.4)%,显著低于对照组【(26.4±5.9)%,P＜0.05】;在术后3个月和6个月时,观察组肿瘤进展率分别为2.0%和5.9%,而对照组则分别为7.8%(P>0.05)和21.6%(P＜0.05)。结论在超声引导下行纳米刀消融治疗不可切除的HCC患者近期临床疗效满意,可能与消融肿瘤实体、增强机体免疫功能有关,值得进一步临床扩大观察。

关键词: 肝细胞癌, 纳米刀消融, 射频消融, 超声引导, 淋巴细胞亚群, 治疗

Abstract: Objective The purpose of this study was to investigate the clinical efficacy and safety of nanoknife irreversible electroporation (IRE) under ultrasound (US) guidance in the treatment of patients with unresectable hepatocellular carcinoma (nrHCC). Methods A total of 102 patients with nrHCC were encountered in our hospital between January 2021 and December 2024, and were assigned to undergo radiofrequency ablation (RFA) under US guidance in 51 cases in control, or undergo nanoknife IRE under US guidance in another 51 cases in observation. Serum alpha-fetoprotein (AFP) level was routinely detected, and peripheral blood lymphocyte subsets was determined by FCM. Results Objective remission rate and disease control rate in the observation group were 64.7% and 84.3%, both significantly higher than 41.2% and 64.7% (both P＜0.05) in the control group; by end of one month after treatment, serum AFP level in the observation group was (96.3±9.6)ng/mL,significantly lower than [(218.7±12.5)ng/mL,P＜0.05] in the control; percentages of peripheral blood CD3⁺ cells, CD4⁺ cells and CD4⁺/CD8⁺ cell ratio were (71.5±9.1)%, (40.7±6.5)% and (1.8±0.4), all significantly higher than [(62.4±8.8)%, (36.8±7.0)% and (1.4±0.3), respectively, P＜0.05], while percentage of CD8⁺ cells was (22.1±5.4)%, significantly lower than [(26.4±5.9)%, P＜0.05] in the control; by end of three month and six month after treatment, disease progression rates in the observation group were 2.0% and 5.9%, and in the control were 7.8%(P>0.05) and 21.6%(P＜0.05). Conclusion Nanoknife IRE under US guidance is short-termly effective in treatment of patients with nrHCC, which might improve body immune system functions.

Key words: Hepatocellular carcinoma, Nanoknife irreversible electroporation, Radiofrequency ablation, Ultrasound guidance, Lymphocyte subsets, Therapy

郝秀秀, 张朝赫, 武翀, 靳福全, 张伟, 周婕, 查润民, 张一峰, 韩治宇, 周赟. 超声引导下纳米刀消融治疗肝细胞癌患者效果分析^*[J]. 实用肝脏病杂志, 2026, 29(3): 421-424.

Hao Xiuxiu, Zhang Chaohe, Wu Chong, et al. Nanoknife irreversible electroporation under ultrasound guidance in the treatment of patients with unresectable hepatocellular carcinoma[J]. Journal of Practical Hepatology, 2026, 29(3): 421-424.

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超声引导下纳米刀消融治疗肝细胞癌患者效果分析^*

Nanoknife irreversible electroporation under ultrasound guidance in the treatment of patients with unresectable hepatocellular carcinoma

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