超声引导下射频消融术治疗肝癌疗效及预后影响因素分析

摘要

目的:分析超声引导下射频消融术治疗肝癌患者的1临床资料,评价治疗效果及其影响因素,为临床应用提供参考依据.方法:回顾性分析2010年7月～2012年7月广州医科大学附属第三医院普外一区进行超声引导下经皮穿刺射频消融术(RFA)治疗肝癌80例患者的临床资料,对患者影像学资料进行分析,统计完全消融病例;同时,将可能影响预后的危险因素进行单因素分析,并筛选单因素分析有差异选项进行logistic线性回归分析,旨在明确RFA治疗肝癌的疗效及影响其预后的主要危险因素.结果:80例肝癌患者共行94次RFA治疗,其中12例肝癌患者接受RFA治疗的次数≥2次,共处理102个病灶,完全消融病灶为84个(82.35％),不完全消融病灶18个(17.65％);完全消融患者术后1、2、3年的生存率分别为79.41％、61.76％、36.76％;且肝功能Child-Pugh分级、肿瘤数目及是否有血管癌栓形成均为影响肝癌患者射频消融术后生存率的独立因素.结论:RFA作为局部微创治疗手段,能使肝癌患者取得一定生存获益,但其预后与肝功能Child-Pugh分级、肿瘤数目、血管癌栓形成具高度相关性.%Objective To provide some references for the clinical application of ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) by analyzing the clinical data of HCC patients treated with RFA and evaluating the therapeutic effect and the factors affecting the prognosis.Methods The clinical data of 80 HCC patients receiving RFA in the Third Hospital Affiliated to Guangzhou Medical University between July 2010 and July 2012 were analyzed retrospectively.The imaging data of patients were analyzed,and cases receiving complete ablation were statistically analyzed.After the factors that may affect the prognosis were analyzed by univariate analysis,the factors with differences were analyzed with logistic linear regression analysis in order to determine the major factors affecting the prognosis.Results All of the 80 HCC patients received a total of 94 times of RFA,of whom there were 12 cases receiving more than twice of RFA.Among the 102 lesions which were treated by RFA,84 lesions (82.35％) were completely ablated and 18 lesions (17.65％) were incompletely ablated.The 1-year,2-year and 3-year survival rates of patients receiving complete ablation were 79.41％,61.76％ and 36.76％,respectively.Child-Pugh grade of liver function,number of tumors and vascular tumor thrombus formation were the independent factors affecting the survival rate of patients after RFA for HCC.Conclusion As a local minimally invasive treatment,RFA can benefit HCC patients.The prognosis is highly correlated with Child grade of liver function,number of tumors and the formation of vascular tumor thrombus.