比较射频消融（RFA）和手术切除治疗小肝细胞癌（肝癌）的疗效。

回顾性分析2009年1月至2014年12月郑州人民医院收治的60例小肝癌患者临床资料。患者均签署知情同意书，符合医学伦理学规定。按照治疗方式的不同将患者分为RFA组和手术切除组（切除组），每组各30例。其中RFA组中，男20例，女10例；年龄45～76岁，中位年龄59岁。切除组中，男22例，女8例；年龄37～71岁，中位年龄57岁。两组围手术期情况比较采用t检验，生存分析采用Kaplan-Meier法和Log-rank检验。

两组患者围手术期无死亡。RFA组患者手术时间、术中出血量、术后住院时间分别为（40±12） min、（24±10） ml、（8.7±1.7） d，明显低于切除组的（132±31） min、（357±138） ml、（16.1±2.6） d（t=-6.686，-6.716，-12.926；P<0.05）。RFA组围手术期ALT、AST最大差值分别为（90±24）、（66±18）U/L，明显低于切除组的（144±35）、（114±34）U/L （t=-6.965，-6.711；P<0.05）。RFA组术后1、2、3年无瘤生存率分别为83%、63%、43%，总体生存率分别为97%、83%、63%；切除组相应为87%、70%、50%和97%、87%、70%。两组术后无瘤生存率和总体生存率比较差异无统计学意义（χ²=0.052，0.018；P>0.05）。

对于直径≤3 cm的小肝癌，RFA治疗安全、有效、微创、经济，可获得与手术切除相近的疗效。

To compare the clinical efficacy between radiofrequency ablation (RFA) and surgical resection for small hepatocellular carcinoma (HCC).

Clinical data of 60 patients with small HCC who were admitted to People's Hospital of Zhengzhou between January 2009 and December 2014 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the treatment method, the patients were divided into the RFA group (n=30) and surgical resection group (resection group, n=30). In the RFA group, 20 cases were males and 10 were females, aged 45-76 years old with a median age of 59 years old. In the resection group, 22 cases were males and 8 were females, aged 37-71 years old with a median age of 57 years old. Clinical data during the perioperative period in two groups were compared using t test. Survival analysis was performed using Kaplan-Meier method and Log-rank test.

No death was observed in two groups during the perioperative period. The operation time, intraoperative blood loss and postoperative length of hospital stay in the RFA group was respectively (40±12) min, (24±10) ml and (8.7±1.7) d, significantly lower than (132±31) min, (357±138) ml and (16.1±2.6) d in the resection group (t=-6.686, -6.716, -12.926; P<0.05). The maximal difference values of ALT and AST in the RFA group during the perioperative period were respectively (90±24) and (66±18) U/L, significantly lower than (144±35) and (114±34) U/L in the resection group (t=-6.965, -6.711; P<0.05). The postoperative 1-, 2-, 3-year tumor-free survival rate and overall survival rate was respectively 83%, 63%, 43% and 97%, 83%, 63% in the RFA group, and was accordingly 87%, 70%, 50% and 97%, 87%, 70% in the resection group. There were no significant differences in the postoperative tumor-free survival rate and overall survival rate between two groups (χ²=0.052, 0.018; P>0.05).

RFA is a safe, efficacious, minimally invasive and economical treatment for small HCC with the diameter ≤3 cm. It can achieve the similar clinical efficacy as the surgical resection.