切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2018, Vol. 07 ›› Issue (06) : 495 -498. doi: 10.3877/cma.j.issn.2095-3232.2018.06.015

所属专题: 文献

临床研究

超声引导下热消融治疗肝少见肿瘤疗效初步探讨
吴莉莉1, 陈佳鑫1,(), 李凯1, 苏中振2, 曾庆劲1, 龙颖琳1, 罗丽萍1, 许尔蛟1, 郑荣琴1   
  1. 1. 510630 广州,中山大学附属第三医院超声科
    2. 519000 珠海,中山大学附属第五医院超声科
  • 收稿日期:2018-08-29 出版日期:2018-12-10
  • 通信作者: 陈佳鑫
  • 基金资助:
    广东省自然科学基金(2016A030313205); 广东省科技计划项目(2015A020214009,2016A020215072,2017A020215082)

Clinical efficacy of ultrasound-guided thermal ablation in treatment of rare liver tumors

Lili Wu1, Jiaxin Chen1,(), Kai Li1, Zhongzhen Su2, Qingjin Zeng1, Yinglin Long1, Liping Luo1, Erjiao Xu1, Rongqin Zheng1   

  1. 1. Department of Ultrasound, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
    2. Department of Ultrasound, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China
  • Received:2018-08-29 Published:2018-12-10
  • Corresponding author: Jiaxin Chen
  • About author:
    Corresponding author: Chen Jiaxin, Email:
引用本文:

吴莉莉, 陈佳鑫, 李凯, 苏中振, 曾庆劲, 龙颖琳, 罗丽萍, 许尔蛟, 郑荣琴. 超声引导下热消融治疗肝少见肿瘤疗效初步探讨[J/OL]. 中华肝脏外科手术学电子杂志, 2018, 07(06): 495-498.

Lili Wu, Jiaxin Chen, Kai Li, Zhongzhen Su, Qingjin Zeng, Yinglin Long, Liping Luo, Erjiao Xu, Rongqin Zheng. Clinical efficacy of ultrasound-guided thermal ablation in treatment of rare liver tumors[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(06): 495-498.

目的

探讨超声引导下热消融治疗肝少见肿瘤的安全性和疗效。

方法

回顾性分析2012年1月至2016年12月在中山大学附属第三医院行超声引导下热消融的9例肝少见肿瘤患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男2例,女7例;平均年龄(42±12)岁。9个病例共14个病灶。所有患者均在超声或超声造影引导下肝肿瘤穿刺,行热消融治疗。术中超声造影即时评估消融疗效,观察术后并发症发生率等。CT、MRI评价术后1个月完全消融率。

结果

11个病灶在普通超声引导下消融,3个病灶在超声造影引导下消融。术中肿瘤完全消融率为14/14,术后1个月肿瘤完全消融率亦为14/14。无消融相关并发症发生。随访期间所有患者均未出现局部肿瘤进展及肝内外肿瘤复发。

结论

对于肝少见肿瘤,超声引导下热消融可达到完全消融的效果,为此类患者提供了新的治疗选择。

Objective

To investigate the safety and efficacy of ultrasound-guided thermal ablation in the treatment of rare liver tumors.

Methods

Clinical data of 9 patients with rare liver tumors who underwent ultrasound-guided thermal ablation from January 2012 to December 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among 9 cases (14 lesions), 2 patients were male and 7 female, aged (42±12) years on average. All the patients underwent ultrasound or contrast-enhanced ultrasound-guided puncture and thermal ablation of the tumors. The ablation effect was evaluated immediately by contrast-enhanced ultrasound during the operation. The incidence of postoperative complications was observed. The complete ablation rate was evaluated by CT or MRI at postoperative1 month.

Results

11 lesions were treated with common ultrasound-guided thermal ablation and 3 lesions with contrast-enhanced ultrasound-guided ablation. The intraoperative complete ablation rate was 100% (14/14), and the rate at postoperative 1 month was also 100% (14/14). No ablation related complications was observed. During the follow-up, no local tumor progression or intrahepatic and extrahepatic tumors recurrence was observed in all patients.

Conclusions

For rare liver tumors, ultrasound-guided thermal ablation can achieve the effect of complete ablation, providing a new therapeutic option for the patients.

表1 9例肝少见肿瘤患者基本资料
[1]
Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update[J]. Hepatology, 2011, 53(3):1020-1022.
[2]
European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(4):908-943.
[3]
Lee DH, Lee JM. Primary malignant tumours in the non-cirrhotic liver[J]. Eur J Radiol, 2017, 95:349-361.
[4]
Dietrich CF, Lorentzen T, Appelbaum L, et al. EFSUMB guidelines on interventional ultrasound (INVUS), part Ⅲ-abdominal treatment procedures (long version)[J]. Ultraschall Med, 2016, 37(1):E1-32.
[5]
Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma[J]. J Hepatol, 2012, 57(4):794-802.
[6]
Kudo M, Matsui O, Izumi N, et al. JSH consensus-based clinical practice guidelines for the management of hepatocellular carcinoma: 2014 update by the Liver Cancer Study Group of Japan[J]. Liver Cancer, 2014, 3(3/4):458-468.
[7]
Van Beers BE, Daire JL, Garteiser P. New imaging techniques for liver diseases[J]. J Hepatol, 2015, 62(3):690-700.
[8]
Belghiti J, Cauchy F, Paradis V, et al. Diagnosis and management of solid benign liver lesions[J]. Nat Rev Gastroenterol Hepatol, 2014, 11(12):737-749.
[9]
Tominaga K, Kamimura K, Sakamaki A, et al. Intraductal papillary neoplasm of the bile duct: a rare liver tumor complicated by malignancy[J]. Hepatology, 2017, 66(5):1695-1697.
[10]
李增才, 张斌, 王轩, 等. 成人肝脏少见肿瘤或肿瘤样变18例临床观察[J]. 临床肿瘤学杂志, 2015, 20(9):837-840.
[11]
李明信, 朱贤胜, 陈育洪, 等. 肝炎性肌纤维母细胞瘤超声表现[J]. 临床超声医学杂志, 2015, 18(1): 72,封3.
[12]
Tapper EB, Lok ASF. Use of liver imaging and biopsy in clinical practice[J]. N Engl J Med, 2017, 377(23):2296-2297.
[13]
孙一欣, 程文, 杨洪艳, 等. 超声造影对提高肝多发占位穿刺活检的应用价值[J]. 中国临床医学影像杂志, 2013, 24(5):325-327, 333.
[14]
郭曦, 唐继红, 付必莽, 等. 45例肝脏少见良性实性占位性病变的临床诊治分析[J]. 肝胆外科杂志, 2012, 20(3):174-176.
[15]
Chinnaratha MA, Chuang MY, Fraser RJ, et al. Percutaneous thermal ablation for primary hepatocellular carcinoma: a systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2016, 31(2):294-301.
[16]
中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017年版)[J]. 临床肝胆病杂志, 2017, 33(8):1419-1431.
[17]
步向阳, 王一, 葛忠, 等. 小肝癌射频消融与手术切除的疗效比较[J/CD]. 中华普通外科学文献(电子版), 2009, 3(2):127-13.
[18]
Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update[J]. Radiology, 2014, 273(1):241-260.
[19]
高孟, 李开艳, 罗洪昌, 等. 原发性小肝癌超声引导下经皮微波消融与手术切除疗效的对比研究[J]. 中华超声影像学杂志, 2015, 24(1):35-39.
[20]
Claudon M, Dietrich CF, Choi BI, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver-update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS[J]. Ultrasound Med Biol, 2013, 39(2):187-210.
[21]
陈敏华, 严昆, 戴莹, 等. 肝超声造影应用指南(中国) (2012年修改版)[J]. 中华超声影像学杂志, 2013, 22(8):696-722.
[1] 罗辉, 方晔. 品管圈在提高甲状腺结节细针穿刺检出率中的应用[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 972-977.
[2] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[3] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[4] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[5] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[6] 陆镜明, 韩大为, 任耀星, 黄天笑, 向俊西, 张谞丰, 吕毅, 王傅民. 基于术前影像组学的肝内胆管细胞癌淋巴结转移预测的系统性分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 852-858.
[7] 吴雪云, 胡小军, 范应方. 肝切除术中剩余肝再生能力的评估与预测[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 894-897.
[8] 林小勇, 张兰霞, 曾庆劲, 贺需旗, 谭雷, 郭光辉, 龙颖琳, 李凯, 吴宇轩. 负压抽吸活检针在肝困难病灶活检中的初步应用研究[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 694-698.
[9] 雷永琪, 刘新阳, 杨黎渝, 铁学宏, 俞星新, 耿志达, 刘雨, 陈政良, 惠鹏, 梁英健. 肝脏血管周上皮样细胞肿瘤合并贫血一例并文献复习[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 710-718.
[10] 欧阳佳裕, 李刚, 贺露瑶, 罗娜. 双层探测器光谱CT在早期原发性肝癌中的诊断价值[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 557-561.
[11] 王凯飞, 牟怡平, 李晓辉, 王瑞涛, 侯惠莲, 张月浪. 原发性肝平滑肌肉瘤临床病理特征及疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 357-362.
[12] 陈志坚, 俞建达, 池小斌, 吕立志, 陈永标. 三维可视化技术在腹腔镜肝巨大肿瘤切除中的应用价值[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 302-307.
[13] 黄俊豪, 陈宗杰, 胡添松. 血小板相关参数对肝内胆管细胞癌根治性切除患者预后预测价值[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 308-312.
[14] 马欢欢, 马晨辉, 邓小博, 王博方, 何普毅, 王云鹏, 许博, 俞荣, 王娜, 陈昊. 肝癌实体瘤治疗疗效评价系统的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 377-383.
[15] 张婵, 吕瑶, 张小燕, 张鸣青. 不同时机局部神经阻滞在开腹肝切除中的镇痛效果比较[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(02): 189-194.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?