【摘要】 目的分析超声引导经皮微波消融(MWA)治疗肝转移癌的疗效。方法应用超声引导下经皮MWA技术治疗肝转移癌共27例69个结节,直径为0.9～13.2(3.0±2.0)cm。观察局部疗效、局部复发率、再发率及生存率。所有病例均签署知情同意书。结果判断局部疗效的完全消融(CA)率为92.8%(64/69),其中,结节直径<3.0cm、3.0～5.0cm及≥5.0cm组的CA率分别为100%(34/34)、92.3%(24/26)和66.7%(6/9),直径≥5.0cm组CA率明显低于其他两组(P<0.05)。结节局部复发率为9.4%(6/64),其中结节直径<3.0cm、3.0～5.0cm及≥5.0cm组的结节复发率分别为2.9%(1/34)、16.7%(4/24)和16.7%(1/6)。判断肝内其他部位出现新转移灶的再发率为44.4%(12/27)。随访时间为3～34(17.0±8.7)个月。6个月、1年及2年的累积生存率分别为88.9%、63.0%及34.4%,平均生存期17.8个月,中位生存期19.0个月。结论经皮MWA治疗肝转移癌的局部疗效满意,对复发或再发病例可以反复治疗,能够延长生存期。更多还原

【Abstract】 Objective To evaluate the therapeutic effects of percutaneous microwave ablation(MWA)for metastatic liver cancer.Methods Ultrasound-guided percutaneous MWA technique was used to treat 27 cases of hepatic metastases with 69 nodules 〔0.9-13.2(3.0±2.0)cm in diameter〕.Local therapeutic effect,local and distant recurrence rate and survival rate were evaluated respectively.Results The complete ablation(CA)rate which was used to evaluate the local therapeutic effects was 92.8%(64/69),with 100%(34/34),92.3%(24/26)and 66.7%(6/9)in a diameter of nodules <3.0 cm,3.0-5.0 cm and ≥5.0 cm respectively.The CA rate was lower in the group of a diameter of nodules ≥5.0 cm as compared with other two groups(P<0.05).The local recurrence rate was 9.4%(6/64),with 2.9%(1/34),16.7%(4/24)and 16.7%(1/6)in a diameter of nodules <3.0 cm,3.0-5.0 cm and ≥5.0 cm respectively.The intrahepatic distant recurrence rate was 44.4%(12/27).The follow-up time after MWA was 3-34(17.0±8.7)months.During the follow-up period,6 months,1-and 2-year cumulative survival rate was 88.9%,63.0% and 34.4% respectively,with a mean survival time of 17.8 months,and with a median survival time of 19.0 months.Conclusion Percutaneous MWA treatment offers satisfactory local tumoricidal efficacy to metastatic liver cancer and the patients with recurrence and new metastases can be therapy repeatedly to improve long-term survival.更多还原