实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (5): 698-701.doi: 10.3969/j.issn.1672-5069.2022.05.023

• 肝癌 • 上一篇    下一篇

超声融合导航技术指导微波消融治疗小肝癌临床价值研究*

李季, 周仲松, 郜玉峰, 薛继华, 张骏飞   

  1. 230022 合肥市 安徽医科大学第一附属医院感染病科
  • 收稿日期:2022-04-29 出版日期:2022-09-10 发布日期:2022-09-22
  • 通讯作者: 张骏飞,E-mail: zhangjunfei105@aliyun.com
  • 作者简介:李季,男,38岁,大学本科,主治医师。主要从事肝癌的影像学诊断和微波消融治疗研究。E-mail: 274343012@qq.com
  • 基金资助:
    安徽省中央引导地方科技发展项目(编号:201907d0750008);安徽省自然科学基金青年基金资助项目(编号:1608085QH172);合肥市借转补基金项目(编号:J2019Y04)

Short-term clinical efficacy of microwave ablation under the guidance of ultrasound fusion imaging in the treatment of patients with small primary liver cancer

Li Ji, Zhou Zhongsong, Gao Yufeng, et al.   

  1. Department of Infectious Diseases, First Affliated Hospital, Anhui Medical University, Hefei 230022, Anhui Province, China
  • Received:2022-04-29 Online:2022-09-10 Published:2022-09-22

摘要: 目的 研究应用超声融合导航技术在常规超声检查显示困难的小肝癌患者引导微波消融(MWA)治疗的价值。方法 2018年1月~2022年1月我院诊治的80例原发性肝癌(PLC)患者,其中接受经皮肝动脉导管化疗栓塞术(TACE)治疗40例,接受在超声融合导航技术指导下MWA治疗40例,术后随访。采用ELISA法检测血清甲胎蛋白(AFP)和热休克蛋白-90(Hsp-90)水平。结果 在治疗后1个月复查,MWA治疗组完全缓解率为82.5%,显著高于TACE治疗组的37.5%,差异有统计学意义(P<0.05);在治疗后3个月,MWA治疗组血清AFP和Hsp90水平分别为(15.2±9.3)μg/L和(63.5±7.8)ng/ml,显著低于TACE治疗组【分别为(32.6±10.2)μg/L和(88.4±9.1)ng/ml,P<0.05】; 术后,MWA治疗组肝区疼痛发生率为47.5%,显著低于TACE治疗组的82.5%,差异有统计学意义(P<0.05)。结论 采用超声融合导航技术指导常规超声检查显示困难的小肝癌微波消融治疗可提高肝癌病灶完全消融率,减少术后不良反应,值得进一步研究。

关键词: 原发性肝癌, 融合影像导航, 微波消融, 经皮肝动脉导管化疗栓塞术, 治疗

Abstract: Objective The aim of this study was to investigate the short-term clinical efficacy of microwave ablation (MWA) under the guidance of ultrasound fusion imaging in the treatment of patients with small primary liver cancer (sPLC). Methods 80 patients with sPLC were admitted to our hospital between January 2018 and January 2022,and were divided into two groups,with 40 cases in each group. The patients in the observation group received MWA treatment under the ultrasound fusion imaging guidance, and those in the control group received transcatheter arterial chemoembolization (TACE). Serum alpha-fetoprotein (AFP) and hot-shock protein-90 (HSP-90) levels were assayed by ELISA. Results At the end of one month treatment, the complete response rate in MWA-treated patients was 82.5%, much higher than 37.5% in TACE-treated patients (P<0.05); at the end of three month treatment, serum AFP and HSP-90 levels in MWA-treated patients were (15.2±9.3)μg/L and (63.5±7.8)ng/ml, significantly lower than [(32.6±10.2)μg/L and (88.4±9.1)ng/ml, respectively, P﹤0.05] in TACE-treated patients; after operation, the incidence of local pain in MWA-treated patients was 47.5%, much lower than 82.5% in TACE-treated patients (P<0.05). Conclusions The application of MWA under the guidance of ultrasound fusion imaging in the treatment of patients with sPLC is efficacious, which could improve the complete ablation rate of lesions, and worthy of clinical verification.

Key words: Hepatoma, Microwave ablation, Transcatheter arterial chemoembolization, Ultrasound fusion imaging, Therapy