高强度聚焦超声治疗邻近大血管肝癌的有效性及安全性评价

发布时间：2018-05-17 18:22

本文选题：肝肿瘤 + 高强聚焦超声消融　；参考：《肿瘤》2017年05期

【摘要】：目的:研究高强度聚焦超声治疗邻近大血管肝癌的疗效及安全性。方法:对60例邻近大血管肝癌患者进行高强度聚焦超声治疗,治疗后检查治疗前甲胎蛋白(alpha-fetoprotein,AFP)20μg/L患者AFP的变化。术后通过影像学(增强MRI)检查肿瘤消融情况、临近肿瘤大血管灌注情况。观察术后不良反应,并行临床随访。结果:60例患者均完成手术,42例术前AFP20μg/L患者术前AFP为(614.1±130.9)μg/L,治疗1个月后为(277.8±59.2)μg/L,较术前明显下降(P=0.012)。术后1个月影像学检查结果提示,64个肿瘤病灶中完全消融的41个(64.1%),剩下的23个(35.9%)病灶消融率50%;增强MRI静脉期检查邻近肝癌病灶大血管无灌注0例,部分灌注0例。不良反应以肝区疼痛、发热、转氨酶一过性升高为主,经对症处理后均好转;无肝破裂和腹腔内大出血等严重并发症。随访期间死亡26例(43.3%),1年、2年、3年、4年和5年的累积生存率分别为71.3%、53.2%、41.8%、33.4%和33.4%。结论:采用高强度聚焦超声治疗临近大血管的肝癌安全且有效,该方法对邻近病灶的大血管也是安全的。
[Abstract]:Objective: to study the efficacy and safety of high intensity focused ultrasound (HIFU) in the treatment of adjacent macrovascular liver cancer. Methods: 60 patients with adjacent macrovascular liver cancer were treated with high intensity focused ultrasound. The changes of AFP in 20 渭 g / L patients with alpha-fetoprotein were examined after treatment. After operation, the ablation of tumor was examined by enhanced MRI, and the perfusion of large vessels near the tumor was examined. Postoperative adverse reactions were observed and followed up. Results the AFP of 42 patients with AFP20 渭 g / L was 614.1 卤130.9 渭 g / L before operation and 277.8 卤59.2 渭 g / L after one month treatment, which was significantly lower than that before operation. One month after operation, the results of imaging examination showed that 41 of the 64 tumor lesions were completely ablated, and the remaining 23 lesions were 35. 9%) the ablation rate was 50 and 50% respectively, and the venous phase of enhanced MRI showed that there was no major vessel perfusion in 0 cases and partial perfusion in 0 cases. The main adverse reactions were liver pain, fever, transaminase transient elevation, and no severe complications such as liver rupture and intraperitoneal hemorrhage. The cumulative survival rates of 1, 2, 3, 4 and 5 years were 71.3% and 41.8%, respectively. Conclusion: high intensity focused ultrasound (HIFU) is safe and effective in the treatment of hepatocellular carcinoma (HCC) adjacent to large vessels.
【作者单位】：重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地——重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室;重庆医科大学附属第二医院肿瘤中心;
【基金】：国家重点基础研究发展计划(973)资助项目(编号:2011CB707900) 创新医疗器械临床评价与应用示范资助项目(编号:cstc2015jcsf10002-14)~~
【分类号】：R735.7

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