Abstract: Objective The aim of this study was to investigate the clinical efficacy of ultrasound-guided microwave ablation (MWA) after transcatheter arterial chemoembolization (TACE)ACE in the treatment of patients with special locations of primary liver cancer (PLC). Methods 72 patients with special locations (adjacent to the top of the diaphragm, gallbladder, gastrointestinal tract, portal vein, hepatic vein, inferior vena cava, right kidney and heart with the shortest distance less than 0.5 cm) of primary liver cancer (observation group) and 60 patients with PLC (control group) were encountered in our hospital between November 2017 and all patients were treated with TACE and thereafter ultrasound-guided MWA combination therapy. The patients were followed-up for 24 months. Serum alpha-fetoprotein (AFP) were detected by chemiluminescence, and serum alpha-fetoprotein heterogeneity L3 (AFP-L3), vascular endothelial growth factor (VEGF) and S100 calcium-binding protein A4 (S100A4) were detected by ELISA. Results At the end of 1 month after treatment, the disease control rate in the observation group was 91.7%, not statistically significantly different as compared to 93.3% in the control (P>0.05); serum AFP, AFP-L3, VEGF and S100A4 levels in the observation group were (123.4±13.7) ng/mL, (82.5±10.7) mg/mL, (250.4±46.8) pg/mL and (52.7±13.4) mg/L, not significantly different as compared to [(120.8±15.6) ng/mL, (80.6±10.1) mg/mL, (248.7±47.3) pg/mL and (50.9±14.5) mg/L, respectively, P>0.05];at 6, 12, 18 and 24 month, the cumulative survival rates in the observation group were 95.8%, 88.9%, 69.4% and 45.8%, not significantly different as compared to 100.0%, 91.7%, 73.3% and 48.3%, respectively, in the control (P>0.05). Conclusion The short-term and long-term efficacy and safety of ultrasound-guided MWA therapy after TACE in the treatment of patients with special locations of liver cancer are similar to those with ordinary liver cancer, which is worthy of clinical verification.

Key words: Hepatoma, Microwave ablation, Transcatheter arterial chemoembolization, Alpha-fetoprotein heterogeneity L3, Vascular endothelial growth factor, Therapy