微波消融治疗肝转移癌临床疗效及影响生存率的相关因素研究

摘要

Objective To study the clinical efficacy and factors influencing the survival rate in patients with liver me-tastases treated by microwave ablation (MWA). Method The medical profiles of 100 patients with clinically confirmed liver metastases were analyzed, all primary tumors were controlled. After MWA treatment for 1 month, appropriate ultra-sonography, contrast-enhanced ultrasound, CT, MRI examination were selected to determine the curative effect. In 1 month after surgery, ultrasonography, liver function and tumor markers tests were performed regularly, and patients were followed up through telephone or as outpatient. Result The complete ablation rate in patients with different tumor diam-eters were of significant differences (P<0.05), while the recurrence rates were similar in these patients (P>0.05). The pri-mary tumor site, tumor diameter, number of tumors, differentiation degree were all associated with the survival rate of pa-tients (P<0.05);while gender, age and extrahepatic metastases were not (P>0.05). Multivariate analysis showed that the primary tumor site and the number of tumors were independent risk factors of liver metastases (P<0.05). Conclusion Mi-crowave ablation is effective in the treatment of liver metastases, and it is a simple procedure with ideal tolerance;that the primary tumor site and number of tumor are independent risk factors in patients with liver metastases.%目的 研究微波消融(MWA)治疗肝转移癌的临床疗效及影响生存率的相关因素.方法 收集经检查确诊为肝转移癌行MWA治疗的100例患者的病历资料,所有病例原发肿瘤均已控制.MWA 1个月后根据患者情况选行B超、超声造影、CT、MRI检查判断疗效.术后1个月后行B超、肝功能及肿瘤标志物检查,定期复查.定时进行电话或门诊随访.结果 不同肿瘤直径患者的完全消融率比较,差异有统计学意义(P﹤0.05);不同肿瘤直径患者的复发率比较,差异无统计学意义(P﹥0.05).原发肿瘤部位、肿瘤直径、肿瘤数目、分化程度与患者的生存率有关(P﹤0.05);性别、年龄、是否肝外转移与患者的生存率无关(P﹥0.05).多因素分析结果表明原发肿瘤部位与肿瘤数目均为肝转移癌患者预后的独立危险因素(P﹤0.05).结论 MWA对治疗肝转移癌的治疗效果良好,具有操作简单、耐受性好等优点;原发肿瘤部位与肿瘤数目均为肝转移癌患者预后的独立危险因素.