·1822·
徐建波，等
原发性中小肝癌手术与射频消融治疗的疗效分析
原发性中小肝癌手术与射频消融治疗的疗效分析徐建波，祁付珍，许刚，张建淮，陈国锋
Comparison ofthe efficacy ofradiofrequencyablation andsurgical resectionforthetreat-
mentof small primaryhepatocellularcarcinoma Xu Jianbo,Qi Fuzhen,Xu Gang,Zhang Jianhuai,Chen Guofeng
Department of General Surgery,Huaian First Peoples Hospital,Nanjing Medical University,Jiangsu Huaian 223300, China.
[Abstract)Objective :To compare the efficacy of radiofrequency ablation (RFA) and surgical resection (SR) for the treatment of small primary hepatocellular carcinoma ( SHCC). Methods: From January 2003 to June 2009, one aoosaaureainadaeasoeesaedoaagea imaging( MRI) or computer tomography( CT) were analyzed retrospectively. 60 SHCC patients were undergone RFA treatment and 65 SHCC patients were undergone SR treatment. The number of RFA by guided B ultrasound,laparosco-Py and CT were fifty five,six and three cases , The number of SR by local tumor resection,hepatic segments resec-tion and hepatic lobectomy were forty - eight,twelve and five cases, Comparison of the treatment effects of two groups was evaluated and compared, Results : The overall survival rates was significantly higher in patients treated with SR than RFA at 1,2 and 3 years (93. 85% ,80. 00% ,72. 31% versus 88. 33% ,71. 67% ,58. 33% ). The difference be tween the survival curves was statistically significant( P =0. 043). The 1 ,2 ,and 3 years recurrence rate after RFA and as%*%9%e%99s9%00am two groups was statistically significant( P s 0. 034). Conclusion: Though radiofrequency catheter ablation has faster postoperative recovery ,less bleeding,shorter hospital stay,less cost and so on,RFA was inferior to SR in terms of o-verall survival rates and recurrence rates at 1,2, and 3 years.
[ Key words]hepatocellular carcinoma;radiofrequency ablation ;surgical resection
Moderm Oncology 2013,21(08) :1822 1825
【摘要】
目的：比较射频消融（radiofrequencyablation，RFA）治疗与手术切除治疗（surgicalresection，SR）对于
原发性小肝癌的疗效。方法：2003年1月到2009年6月共收治经甲胎蛋白（AFP)联合影像学（MRI或CT)证实的原发性中小肝瘤患者125例：RFA组60例(B超引导下经皮射频消融51例，腹腔镜下射频消融6例，CT 定位经皮射频消融3例），SR组65例：采用常规手术切除治疗（肿瘤局部挖出48例，肝段切除12例，肝叶切除5 例)。评估并比较两组治疗效果。结果：RFA组和SR组术后第1.2和3年生存率分别为88.33%、71.67%、58.33%和 93.85%、80.00%和72.31%，两者的生存曲线采用Kaplan=Meier检验有统计学意义（P=0.043）。RFA组和%999900 比较，复发率差异有统计学意义（P=0.034）。结论：射频消融治疗虽具有术后恢复快、出血量少、住院日短、
花费少等微创特点，但在肿瘤复发率和术后生存率方面不如传统手术切除治疗。【关键词】肝癌；射频消融；手术
【中图分类号】R735.7
【文献标识码】A
【文章编号】1672-4992(2013)08182204 原发性肝癌是世界范围内最常见的五大恶性肿瘤之一
【收日期】【修回日期】【作者单位】
【作者简介】【通讯作者】
2012 1203 2012 12 22
南京医科大学附属淮安第一人民医院普通外科，江苏准安223300
徐建波（1987－），男，江苏准安人，在读硕士，主要从事研究肝癌的微创治疗。E-mail;xu240189931@ 163.com
张建准（1959－），男，江苏准安人，主任医师，主要从事肝癌的综合治疗.E-mail：Jh_z02@hotmail.com
DOI:10.3969/j. issn. 1672 4992.2013. 08.51
同时大多数病人在亚洲和非洲，主要与病毒感染（HBV或 HCV)有关，而我国肝癌具有发病率高，危害性大，病死率高等特点。
目前肝脏恶性肿瘤的最佳疗法仍是外科切除，但肝癌的
发病十分隐诺，临床上仅有不到30%的病人就诊时可获得手术治疗的机会，同时病人术后肝癌复发率很高，肿瘤复发后的处理也相对较为困难[1]。因此非手术治疗特别是近20年发展起来的经皮射频消融（percutaneous local ablativethera Py，PLAT)得到了广泛关注，然而经皮无水酒精注射（percuta-neousethanol injection，PEI）因其术后2年复发率超过50%已