射频消融治疗原发性肝癌患者疗效评价*

doi:10.3969/j.issn.1672-5069.2022.05.028

摘要/Abstract

摘要： 目的观察射频消融治疗原发性肝癌(PLC)患者的疗效。方法 2017年6月～2020年8月我院诊治的62例PLC患者,均接受射频消融术(RFA)治疗和行磁共振成像(MRI)检查评估疗效。采用电化学发光法检测血清甲胎蛋白(AFP)、人热休克蛋白90α(HSP90α)、糖类抗原125(CA125)和糖类抗原199(CA199)。结果在治疗后1 m复查,获得完全应答12例(19.4%)、部分应答21例(33.9%),无应答29例(46.8%);完全应答组血清AFP、HSP90α和CA199水平分别为(85.6±5.2)ng/mL、(112.3±29.2)ng/mL和(32.3±12.4)U/mL,显著低于部分应答组【分别为(334.2±42.3)ng/mL、(124.2±19.6)ng/mL和(45.3±12.5)U/mL,P<0.05】或无应答组【分别为(679.5±48.4)ng/mL、(143.9±33.5)ng/mL和(64.6±16.1)U/mL,P<0.05】;治疗前,完全应答组、部分应答组和无应答组病灶表观扩散系数(ADC)分别为(1.23±0.47)mm²/s、(1.21±0.57)mm²/s和(1.22±0.31)mm²/s(P>0.05),治疗后分别为(1.72±0.25)mm²/s、(1.63±0.14)mm²/s和(1.34±0.22)mm²/s(P<0.05)。结论采用RFA治疗PLC患者可获得较好的短期临床疗效,进行手术前后MRI检查有助于对疗效的评估。

关键词: 原发性肝癌, 射频消融, 磁共振检查, 治疗

Abstract: Objective The aim of this study was to investigate the short-term efficacy of radiofrequency ablation (RFA) in treatment of patients with primary liver cancer (PLC). Methods 62 patients with PLC were enrolled in our hospital between June 2017 and August 2020, and all underwent RFA therapy. The short-term efficacy was evaluated by MRI comparison. Serum alpha-fetoprotein (AFP), human heat shock protein-90α(HSP90α), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) were assayed. Results At the end of one-month treatment, the complete remission (CR) was obtained in 12 cases(19.4%), partial remission (PR) in 21 cases (33.9%) and non-remission (NR) in 29 cases (46.8%); serum AFP, HSP90α and CA199 levels in patients with CR were (85.6±5.2)ng/mL,(112.3±29.2)ng/mL and (32.3±12.4)U/mL, significantly higher than [(334.2±42.3)ng/mL,(124.2±19.6)ng/mL and (45.3±12.5)U/mL, respectively, P<0.05] in patients with PR or [(679.5±48.4)ng/mL, (143.9±33.5)ng/mL and (64.6±16.1)U/mL, respectively, P<0.05] in patients with NR; at presentation, the apparent diffusion coefficient (ADC) of cancerous foci in patients with CR, PR and NR were(1.23±0.47)mm²/s, (1.21±0.57)mm²/s and (1.22±0.31)mm²/s(P>0.05), while after treatment, they were (1.72±0.25)mm²/s,(1.63±0.14)mm²/s and (1.34±0.22)mm²/s, significantly different (P<0.05). Conclusion The RFA therapy in dealing with patients with PLC could gain a good short-term efficacy, and the MR scan could help evaluate the clinical response objectively.

Key words: Hepatoma, Radiofrequency ablation, Magnetic resonance imaging, Therapy

周宇, 耿进朝, 韩雪, 于建华, 回瑾, 李岩, 李微. 射频消融治疗原发性肝癌患者疗效评价^*[J]. 实用肝脏病杂志, 2022, 25(5): 718-721.

Zhou Yu, Geng Jinchao, Han Xue, et al.. Very short-term efficacy of radiofrequency ablation in treatment of patients with primary liver cancer[J]. Journal of Practical Hepatology, 2022, 25(5): 718-721.

参考文献

[1]Fu J, Wang H. Precision diagnosis and treatment of liver cancer in China. Cancer Lett,2018,1(412):283-288.
[2]Lee J, Shin IS, Yoon WS, et al. Comparisons between radiofrequency ablation and stereotactic body radiotherapy for liver malignancies: Meta-analyses and a systematic review. Radiother Oncol,2020,4(145):63-70.
[3]王鹤,董家鸿,卢实春,等.手术切除与射频消融治疗原发性肝癌患者预后比较.实用肝脏病杂志,2017,20(3):337-340.
[4]HuXY, Li L, Wu HT, et al. Serum miR-130b level, an ideal marker for monitoring the recurrence and prognosis of primary hepatocellular carcinoma after radiofrequency ablation treatment. Pathol Res Pract,2018,214(10):1655-1660.
[5]D'Onofrio M, Cardobi N, Ruzzenente A, et al. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results. Abdom Radiol (NY),2018,43(6):1379-1385.
[6]Yoon J H, Lee J M, Klotz E, et al. Prediction of local tumor progression after radiofrequency ablation (RFA) of hepatocellular carcinoma by assessment of ablative margin using pre-rfa MRI and post-rfa CT registration. Korean J Radiol, 2018,19(6):1053-1065.
[7]Ma X, Ouyang H, Wang S, et al. Histogram analysis of apparent diffusion coefficient predicts response to radiofrequency ablation in hepatocellular carcinoma. Chin J Cancer Res,2019 ,31(2):366-374.
[8]Kan X, Ren Y, Li X,et al. Value of¹⁸F-FDG PET/MRI in the early evaluation of treatment response following radiofrequency ablation of liver cancer in a rabbit model. J Vasc Interv Radiol,2021,1(21)1386-1391.
[9]Khokher S, Qureshi M, Chaudhry N. Comparison of WHO and RECIST criteria for evaluation of clinical response to chemotherapy in patients with advanced breast cancer. Asian Pac J Cancer Prev, 2012,13(7):3213-3218.
[10] Izzo F, Granata V, Grassi R, et al. Radiofrequency ablation and microwave ablation in liver tumors: an update.Oncologist,2019,24(10):990-1005.
[11] Tsili AC, Alexiou G, Naka C, et al. Imaging of colorectal cancerliver metastases using contrast-enhanced US, multidetector CT, MRI, and FDG PET/CT: a meta-analysis. Acta Radiol,2021,62(3):302-312.
[12] Gunter D, Riaz S, Haider EA,et al. Hepatic perfusional changes on CT and MRI: a radiology primer. Abdom Radiol (NY),2021,46(1):179-196.
[13] 殷婷婷,顾红,杨儒牛,等.MRI联合应用DWI和DCE扫描序列在发现肝癌切除术后肝内复发微小癌灶的价值分析.实用肝脏病杂志,2017,20(5):625-626.
[14] Samim M, Molenaar IQ, Seesing MFJ, et al. The diagnostic performance of¹⁸F-FDG PET/CT, CT and MRI in the treatment evaluation of ablation therapy for colorectal liver metastases: A systematic review and meta-analysis. Surg Oncol,2017 ,26(1):37-45.
[15] Popp I, Bott S, Mix M, et al. Diffusion-weighted MRI and ADC versus FET-PET and GdT1w-MRI for gross tumor volume (GTV) delineation in re-irradiation ofrecurrent glioblastoma. Radiother Oncol,2019 ,1(130):121-131.
[16] Pham TT, Liney GP, Wong K,et al. Functional MRI for quantitative treatment response prediction in locally advanced rectal cancer. Br J Radiol,2017 ,90(1072):20151078-200151119.
[17] Ren J, Yuan Y, Wu Y, et al. Differentiation of orbital lymphoma and idiopathic orbital inflammatory pseudotumor: combined diagnostic value of conventional MRI and histogram analysis of ADC maps. BMC Med Imaging,2018,18(1):6-14.
[18] Liu S, Wang M, Zheng C, et al. Diagnostic value of serum glypican-3 alone and in combination with AFP as an aid in the diagnosis of liver cancer. Clin Biochem, 2020, 5(79):54-60.
[19] Sourbier C. Plasma HSP90α and liver cancer: a potential biomarker? EBio Med,2017,11(25):7-8.
[20] Fu Y, XuX, Huang D, et al. Plasma heat shock protein 90 alpha as a biomarker for the diagnosis of liver cancer: An official, large-scale, and multicenter clinical trial. EBio Med,2017,10(24):56-63.

射频消融治疗原发性肝癌患者疗效评价^*

Very short-term efficacy of radiofrequency ablation in treatment of patients with primary liver cancer

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