超声引导经皮热消融治疗肝内胆管细胞癌

摘要

Objective To evaluate the clinical value of percutaneous ultrasound (US)-guided thermal ablation of intrahepatic cholangiocarcinoma. Methods 14 patients (19 nodules) with histolog-ically proven intrahepatic cholangiocarcinoma (ICC) were treated with percutaneous US-guided thermal ablation from Oct. 1998 to Aug. 2009 in our hospital. The local treatment response, complication and survival were retrospectively analyzed. Results 18 (18/19, 94.7%) nodules had complete necrosis, and 1 (1/19, 5.3%) nodule had residual tumor after ablation. There was no mortality associated with thermal ablation. Only 1 (1/14, 7.1%) patient developed portal vein thrombosis. The follow-up ranged from 1.3 to 72.9 months (mean, 19.0±15.1 months; median, 7.25 months), 10 (10/14,71.4%) patients survived less than 1 year, 2 (2/14,14.3%) survived 1-5 years, and 2 (2/14,14.3%) survived more than 5 years. Of the 14 patients, 9 (9/14, 64.3%) had died and 5 (5/14,35.7%) were alive. The causes of death included tumor progression (8/9, 88.9%) and liver failure (1/9, 11.1%). 9 (9/14,64.3%) patients developed recurrence on follow-up. The disease-free survival ranged from 1.1 to 72. 9 months (mean 16.6±26. 3 months; median 4.1 months). Conclusion Percutaneous US-guided thermal ablation therapy using microwave ablation (MWA) or radiofrequency ablation (RFA) is a safe and effective therapy for intrahepatic cholangiocarcinoma.%目的 探讨超声引导经皮热消融治疗肝内胆管细胞癌(intrahepatic cholangiocarcinooma,ICC)的临床价值.方法 1998年10月至2009年8月,14例经病理确诊的ICC患者(19个结节)于我院接受了超声引导下经皮热消融(微波或射频消融)治疗.本文对14例消融治疗的并发症及长期生存进行了回顾性分析.结果 18个结节完全消融(18/19,94.7%),1个(1/19,5.3%)消融不全.14例无一发生与消融相关的死亡,仅出现1例(1/14,7.1%)门静脉血栓.随访时间1.3～72.9个月(平均19.0个月±15.1个月,中位7.3个月).生存1年以下、1～5年、5年以上的患者分别为10例(10/14,71.4%)、2例(2/14,14.3 0A)、2例(2/14,14.3%).随访期间死亡9例(9/14,64.3%),存活5例(5/14,35.7%),肿瘤复发9例(9/14,64.3%).治疗后无瘤生存期1.1～72.9个月(平均16.6个月土26.3个月,中位4.1个月).结论 超声引导经皮热消融治疗ICC安全、有效,具有临床应用价值.