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目的 探讨冷循环射频消融治疗肝癌的方法、适应症及其疗效。方法 应用冷循环射频消融治疗肝细胞癌患者 168例共 217个病灶,其中第 1组 113例共 147个病灶,肿瘤直径 <3cm;第 2组 35例共 49个病灶,肿瘤直径 3~5cm;第 3组 20例共 21个病灶,肿瘤直径>5cm。观察治疗前后患者丙氨酸转氨酶、甲胎蛋白(AFP)、CD4+、CD8+、CD4+ /CD8+值和可溶性白介素 2受体 (sIL 2R)、二维及彩色多普勒血流显像、超声造影、增强CT/MRI的改变。记录患者治疗后 1、2、3年生存率。结果 第 1组病灶完全坏死率为 89. 1% (131 /147),术后 1个月AFP明显下降,术后 1、2、3年生存率分别为 96. 6% (84 /87)、71. 2% (42 /59)和 63. 0% (17 /27)。第2组病灶完全坏死率为 53. 1% ( 26 /49 ),术后 1月AFP下降,术后 1、2、3年生存率分别为 82. 1% ( 23 /28 )、63. 2% (12 /19)和 44. 4% (4 /9)。第 3组仅 4个病灶 (占 19. 0% )为完全坏死,术后 1个月仅 1例AFP下降至25μg/L以下, 1年生存率 62. 5% (10 /16), 2年生存率 44. 4% (4 /9),存活 3年以上仅 1例(1 /4)。20例肝细胞癌患者与健康对照者相比CD4+、CD4+ /CD8+显著降低,sIL 2R显著增高;治疗后CD4+值升高、CD4+ /CD8+值升高,sIL 2R显著降低。结论 射频消融治疗小肝癌可获显著疗效,而对于
Objective To investigate the method, indication and curative effect of cold cycle radiofrequency ablation in the treatment of liver cancer. METHODS: A total of 217 lesions of 168 patients with hepatocellular carcinoma were treated with cold-cycle radiofrequency ablation. Among 113 lesions in group 1, there were 147 lesions with a diameter of less than 3 cm. Group 2 had 35 lesions with a total of 49 lesions with a diameter of 3 to 5 cm. The third group of 20 cases a total of 21 lesions, tumor diameter> 5cm. AFP, CD4 +, CD8 +, CD4 + / CD8 + and soluble interleukin 2 receptor (sIL 2R), two-dimensional and color Doppler flow imaging, contrast-enhanced ultrasound, Enhance CT / MRI changes. Record patient survival 1, 2, 3 years after treatment. Results The complete necrosis rate of lesions in group 1 was 89.1% (131/147), and the level of AFP was significantly decreased at 1 month after operation. The 1-, 2-, 3- year survival rates were 96.6% (84/87) 71. 2% (42/59) and 63. 0% (17/27). The complete necrosis rate of lesions in group 2 was 53.1% (26/49), and the level of AFP decreased 1 month after operation. The 1, 2 and 3-year survival rates were 82.1% (23/28) and 63.2 % (12/19) and 44.4% (4/9). In group 3, only 4 lesions (19.0%) were completely necrotic. Only 1 case of AFP dropped to 25μg / L or less at 1 month after operation. The 1-year survival rate was 62.5% (10/16) and 2 years The survival rate was 44.4% (4/9), and only 1 case (1/4) survived more than 3 years. CD4 +, CD4 + / CD8 + and sIL2R were significantly increased in 20 patients with hepatocellular carcinoma as compared with those in healthy controls. CD4 + / CD8 + and sIL2R were significantly decreased after treatment. Conclusions Radiofrequency catheter ablation can achieve a significant effect in treating small hepatocellular carcinoma, whereas