摘要
目的:探讨经皮微波消融(MWA)治疗肝细胞癌(HCC)的疗效及影响因素。方法:回顾性分析139例行超声、CT引导下经皮MWA治疗的HCC患者(共163个病灶,单个肿瘤最大直径≤5 cm,或2~3个肿瘤、最大直径≤3 cm)的病例资料,统计肿瘤完全消融率、局部肿瘤进展率、肝内远处复发率、无复发生存率、总体生存率,COX比例风险回归模型分析局部肿瘤进展、肝内远处复发及总体生存的影响因素。结果:接受MWA治疗术后1、2、3年局部肿瘤进展率分别为10.2%、21.8%、31.2%;肝内远处复发率分别为28.2%、39.0%、51.9%;无复发生存率分别为65.9%、48.3%、29.7%;总体生存率分别为96.3%、80.4%、67.6%。多因素COX回归分析显示,肿瘤最大直径为局部肿瘤进展的独立危险因素(P=0.039);AFP≥400μg/L、肿瘤最大直径>3 cm、多发肿瘤为肝内远处复发的独立危险因素(P<0.05)。Child-Pugh B级、肿瘤最大直径>3 cm、多发肿瘤为总体生存的独立危险因素(P<0.05)。结论:经皮MWA是治疗HCC的一种有效方法;肿瘤最大直径是局部肿瘤进展、肝内远处复发及总体生存的独立危险因素。AFP≥400μg/L、多发肿瘤是肝内远处复发的独立危险因素;单发肿瘤、Child-Pugh A级、肿瘤最大直径≤3 cm的HCC患者可获得更长的生存时间。
Objective:To evaluate the efficacy and influencing factors of percutaneous microwave ablation(MWA)for the treatment of hepatocellular carcinoma(HCC).Methods:139 HCC patients with 163 nodules(single HCC≤5 cm,no more than three nodules≤3 cm)who underwent percutaneous MWA through the use of ultrasonography(US)or computed tomography(CT)were analyzed.The complete ablation rate,local tumor progression(LTP)rate,intrahepatic distant recurrence(IDR)rate,recurrence-free survival(RFS)rate,and overall survival(OS)rate were analyzed.COX proportional hazards model was used to analyze the influencing factors of LTP,IDR and OS.Results:After receiving MWA treatment for 1,2,and 3 years,the LTP rates were 10.2%,21.8%,31.2%,the IDR rates were 28.2%,39.0%,51.9%,the RFS rates were 65.9%,48.3%,29.7%,and the OS rates were 96.3%,80.4%,67.6%,respectively.Multivariate COX regression analysis showed that the largest tumor size was an independent risk factor for LTP(P=0.039).Alpha fetoprotein(AFP)≥400μg/L,largest tumor size>3 cm,and multinodular HCC were independent risk factors for IDR(P<0.05).Child-Pugh B grade,largest tumor size>3 cm,and multinodular HCC were independent risk factors for OS(P<0.05).Conclusion:Percutaneous MWA is an effective treatment for HCC.Largest tumor size was associated with LTP,IDR and OS.AFP and number of tumors independently predicted IDR.Single HCC,Child-Pugh A grade and largest tumor size≤3 cm were more likely to have a longer overall survival.
作者
杨朝凤
刘鑫
李小英
郭黎
李杨
YANG Chao-feng;LIU Xin;LI Xiao-ying;GUO Li;LI Yang(Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;The People's Hospital of Yuechi County,Guangan 638300,Sichuan,China)
出处
《川北医学院学报》
CAS
2024年第2期209-213,共5页
Journal of North Sichuan Medical College
基金
四川省南充市市校战略合作项目(22SXQT0294)
川北医学院附属医院科研项目(2021LC009)
川北医学院校级科研发展项目(CBY23-QNA51)。
关键词
肝细胞癌
微波消融
疗效
复发
危险因素
Hepatocellular carcinoma
Microwave ablation
Efficacy
Recurrence
Risk factors
