大肝癌根治术前先行射频消融保守治疗的可行性

摘要

Objective To investigate the feasibility of CT-guided radiofrequency ablation for conservative treatment of patients with large hepatocellular carcinoma (LHCC) before radical resection. Methods Patients with secondary large liver cancer were selected as group A(radiofrequency ablation group,n = 27)and group B (surgical treatment group ,n = 33). Liver function ,immunological function ,postoperative complications ,hospi-talization time ,and 3-year relapse-free survival (RFS) were observed between two groups after treatment. Results After treatment,patients′liver function(ALT,AST,ALB,TB),and immune function(CD3+T,CD4+T, CD8+T,CD4+/CD8+,NK,B,Treg)in group A were better than those in group B(P<0.05). There were shorter hospitalization time and lower complication rate in group A when compared with those in group B(P < 0.05)but there was no significant difference regarding to 3-year RFS(P > 0.05). Conclusions Although radiofrequency ablation cannot effectively improve patients′ RFS,but with faster postoperative recovery,less complications,and effective protection for liver function and immune function of patients ,it is a feasible conservative treatment for patients′with LHCC before radical resection.%目的 探讨大肝癌患者根治术前先行CT引导下的射频消融保守治疗的可行性.方法 以近期我院肿瘤内科行射频消融保守治疗和大肝癌根治术的继发性大肝癌患者作为射频消融组(n=27)和手术治疗组(n=33).观察两组患者治疗后肝功能、免疫细胞、术后并发症、住院时间、无复发3年生存率等临床指标差异.结果 治疗后7 d,射频消融组患者肝功能(ALT、AST、ALB、TB)和免疫细胞亚群(CD3+T、CD4+T、CD8+T、CD4+/CD8+、NK、B、Treg)均高于手术治疗组(P<0.05).射频消融组患者住院时间、并发症发生率明显低于手术治疗组(P<0.05).射频消融组无复发3年生存率与手术治疗组相比,差异无统计学意义(P>0.05).结论 继发性大肝癌根治术前先行射频消融保守治疗方案,虽然并不能有效提升患者无复发生存率,但患者术后恢复较快,并发症发生较少,且可有效保护患者肝功能及免疫功能,不失为一种可行的大肝癌根治术前保守治疗方案.