| 摘要: |
| 目的 探讨国产靶向刀冷冻消融治疗早期原发性肝细胞癌的近期疗效及安全性。方法 于2017年1月1日至2019年6月30日，招募上海中医药大学附属龙华医院肿瘤科行CT引导下国产靶向刀冷冻消融治疗的早期原发性肝细胞癌患者共23例。记录冷冻消融术中的影像学信息、不良反应、术后复发和死亡情况，评价国产靶向刀治疗早期原发性肝细胞癌的肿瘤消融情况、手术相关并发症、无进展生存期和1年总生存率。结果 23例患者中21例在国产靶向刀冷冻消融术中冰球完全覆盖肿瘤，2例为不完全覆盖，完全消融率为91.3%（21/23）。23例患者无进展生存期为12.0（7.0，12.0）个月，1年总生存率为95.7%（22/23）。Kaplan-Meier生存分析显示肿瘤长径之和、肿瘤并发症均与靶向刀冷冻消融术后无进展生存有关（P均=0.028）。多因素Cox回归分析显示，肿瘤长径之和与肿瘤并发症是靶向刀冷冻消融术后无进展生存的独立影响因素（P均<0.05）。23例患者术后肝功能均未见明显异常，3例患者出现少量腹水，2例出现少量咯血，均无严重并发症发生。结论 靶向刀冷冻消融治疗早期原发性肝细胞癌安全、有效。 |
| 关键词: 肝肿瘤 肝细胞癌 冷冻消融术 治疗结果 安全性 |
| DOI：10.16781/j.0258-879x.2021.08.0932 |
| 投稿时间：2021-01-05修订日期：2021-03-31 |
| 基金项目:上海申康医院发展中心专科疾病临床“五新”转化项目（16CR3039A）. |
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| Clinical effect of AccuTarget cryoablation for the treatment of early primary hepatocellular carcinoma |
| GU Xiao-qiang1,TAO Hua2,XU Jia-hua1,LI Xin1,LI Hong-wei1,WU Qing1* |
(1. Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China;
2. Department of Radiology, Minhang Hospital, Fudan University, Shanghai 201199, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the short-term efficacy and safety of AccuTarget cryoablation in the treatment of early primary hepatocellular carcinoma. Methods A total of 23 patients with early primary hepatocellular carcinoma who underwent CT-guided AccuTarget cryoablation in the Department of Oncology of Longhua Hospital, Shanghai University of Traditional Chinese Medicine from Jan. 1, 2017 to Jun. 30, 2019 were recruited. The imaging information during cryoablation, adverse reactions, postoperative recurrence, and deaths were recorded to evaluate the ablation, postoperative complications, progression-free survival and 1-year overall survival rate of the early primary hepatocellular carcinoma treated with AccuTarget cryoablation. Results Among the 23 patients, 21 achieved the ice hockey complete coverage of the tumor during AccuTarget cryoablation, 2 cases had incomplete coverage, and the complete ablation rate was 91.3% (21/23). The progression-free survival was 12.0 (7.0, 12.0) months, and the 1-year overall survival rate was 95.7% (22/23). Kaplan-Meier survival analysis showed that the sum of tumor diameter and postoperative complications were related to the progression-free survival after AccuTarget cryoablation (both P=0.028). Multivariate Cox regression analysis showed that the sum of tumor diameter and postoperative complications were independent factors of the progression-free survival after AccuTarget cryoablation (both P<0.05). No obvious abnormality of the liver function was found in the 23 patients, 3 patients had a small amount of ascites, 2 patients had a small amount of hemoptysis, and no serious complications occurred. Conclusion AccuTarget cryoablation is safe and effective in the treatment of early primary hepatocellular carcinoma. |
| Key words: liver neoplasms hepatocellular carcinoma cryoablation treatment outcome safety |
