摘要
目的探讨原发性肝癌射频消融后肿瘤残瘤（即不完全消融）的相关影响因素。方法1999月12月至2007年4月，上海第二军医大学附属东方肝胆外科医院共对1341例原发性肝癌病人的2696个肿瘤实施了超声引导下经皮射频消融治疗。术后1-2个月内复查，统计术后肿瘤残留发生率。结果1142例病人2331个肿瘤得到有效复查资料。132例（11．6％）病人的192个（8．2％）肿瘤射频消融后发生活性组织残留。肿瘤大小、部位、生长方式、术前TACE、射频发生器类型以及超声定位清晰度等指标与术后肿瘤组织残留显著相关，分别为p=0．000，P：0．004，p=0．014，P=0．001和P=0．000。Logistic多因素回归分析表明，只有肿瘤大小、部位、生长方式以及术前TACE是肝癌射频消融后活性组织残留的独立影响因素。结论合理选择肿瘤大小、部位和射频发生器，精确超声定位，术前实施TACE等可降低射频消融后不完全消融率，减少术后肿瘤残留。
Objective To determine the risk factors of the partial response of primary liver cancer after percutaneous radiofrequency ablation （PRFA）. Methods From December 1999 to April 2007,we treated 2331 tumors in 1142 cases of primary liver cancer with PRFA. The 192 of the 2331 tumors achieved a partial response （PR）. We investigated the relationship between 10 pretreatment factors and the partial response of PRFA. Results The overall partial response rate was 8.2% within 2 months after PRFA. Tumor size, tumor location, growth pattern, TACE before PRFA, the electrode pattern and legible orientation of tumor under ultrasound were significantly associated with a higher partial response rate（P=0. 000,P=0. 004,P=0. 014,P=0. 001 and P=0. 000, respectively）. However, only the tumor size, tumor location, growth pattern and TACE before PRFA were found to be independent risk factors for the partial response of primary liver cancer after percutaneous radiofrequency ablation by Logistic regression model. Conclusion The tumor size, tumor location, growth pattern of tumor and TACE before PRFA treatment influence the local efficacy of PRFA for primary liver cancer.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2009年第4期254-258,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
癌
肝细胞
射频消融
肿瘤残留
Carcinoma,hepatocellular
Percutaneous radiofrequency ablation
Partial response
