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目的:研究肝动脉(TACE)、门静脉(PVCE)化疗栓塞联合射频消融(PRFA)治疗在原发性肝癌的治疗中的应用。方法:48例肝癌患者行TACE+PVCE+PRFA综合治疗并与同期单纯行TACE治疗的56例肝癌患者作对照,对比术后1周肝功能损害程度,术后1个月AFP转阴率、肿瘤病灶治疗有效率、门脉癌栓治疗有效率及1～3年生存率。结果:术后1周肝功能损害综合组与对照组差异无统计学意义,P>0.05;术后1个月AFP转阴率综合组87.5%(28/32),对照组59.0%(23/39),两者差异有统计学意义,χ2=4.662,P=0.031;肿瘤病灶治疗有效率综合组91.7%(44/48),对照组76.8%(43/56),两者差异有统计学意义,χ2=4.186,P=0.041;门静脉癌栓治疗有效率综合组66.7%(10/15),对照组31.6%(6/19),两者差异有统计学意义,χ2=4.142,P=0.042;综合组1、2和3年生存率分别为72.9%(35/48)、41.7%(20/48)和22.9%(11/48),对照组分别为58.9%(33/56)、21.4%(12/56)和12.5%(7/56)。结论:TA-CE+PVCE+PRFA综合治疗能显著提高AFP转阴率、肿瘤病灶治疗有效率、门脉癌栓治疗有效率有较好的临床应用价值。
Objective: To study the application of transcatheter arterial chemoembolization combined with radiofrequency catheter ablation (PRFA) in the treatment of primary liver cancer. Methods: Forty-eight patients with hepatocellular carcinoma were treated with TACE + PVCE + PRFA and compared with 56 patients with hepatocellular carcinoma treated with TACE in the same period. The degree of liver dysfunction, the rate of AFP negative conversion one month after operation, Efficacy of lesion treatment, portal vein thrombosis treatment efficiency and 1 to 3 years survival rate. Results: There was no significant difference between the control group and the one week after operation (P> 0.05). One month after the operation, 87.5% (28/32) of AFP negative conversion rate group and 59.0% (23 / 39). There was significant difference between the two groups (χ2 = 4.662, P = 0.031). The effective rate of tumor focus treatment was 91.7% (44/48) in the treatment group and 76.8% (43/56) in the control group, with statistical difference (Χ2 = 4.182, P = 0.041); effective rate of portal vein tumor embolotherapy was 66.7% (10/15) in control group and 31.6% (6/19) in control group, the difference was statistically significant, χ2 = 4.142, P = 0.042. The 1, 2 and 3-year overall survival rates were 72.9% (35/48), 41.7% (20/48) and 22.9% (11/48) in the combined group and 58.9% (33/56) in the control group 21.4% (12/56) and 12.5% (7/56). Conclusion: The combined treatment of TA-CE + PVCE + PRFA can significantly improve the negative rate of AFP, the effective rate of treatment of tumor lesions, and the effective rate of portal vein tumor thrombus treatment have a good clinical value.