微波消融治疗肝癌后局部肿瘤进展的危险因素分析

    Analysis of the risk factors of local tumor progression after liver cancer patients treated with microwave ablation

    • 摘要:
      目的分析行超声引导经皮微波消融术(MWA)后肝癌病人影响局部肿瘤进展(LTP)发生的危险因素。
      方法选择采用MWA治疗的肝癌病人73例共102个病灶为研究对象,对病人的临床资料和术后随访影像学检查资料进行回顾性分析。
      结果LTP总发生率为15.68%(16/102);单因素分析显示,LTP与病人年龄、肿瘤类型及肝脏Child-Pugh分级无关(P>0.05),与肿瘤大小、肿瘤边界是否清晰、肿瘤是否邻近大血管和肿瘤血流灌注程度有关(P < 0.05~P < 0.01);进一步多因素logistic回归分析显示,肿瘤大小>3 cm及肿瘤邻近大血管是LTP的独立危险因素(P < 0.05)。
      结论肿瘤大小>3 cm和邻近大血管是MWA治疗肝癌后发生LTP的独立危险因素,临床治疗中应采取相应措施和策略,从而提高MWA疗效。

       

      Abstract:
      ObjectiveTo analyze the risk factors of local tumor progression(LTP) after liver cancer patients treated with ultrasound-guided percutaneous microwave ablation(MWA).
      MethodsA total of 102 lesions in 73 cases of liver cancer treated with MWA were investigated.The clinical data of the patients and postoperative following-up imaging examination data were retrospectively analyzed.
      ResultsThe total incidence rate of LTP was 15.68%(16/102).The results of univariate analysis showed that the LTP was not related to the age, tumor type, and Child-Pugh classification of liver(P>0.05), and related to the tumor size, clear tumor boundary, tumor adjacence to large blood vessels and tumor blood perfusion degree(P < 0.05 to P < 0.01).The results of further multivariate logistic regression analysis showed that the tumor size >3 cm and tumor adjacence to large blood vessels were the independent risk factors of LTP(P < 0.05).
      ConclusionsThe tumor size >3 cm and adjacence to large blood vessels are the independent risk factors of LTP after liver cancer patients treated with MWA.The corresponding measures and strategies should be taken to improve the efficacy of MWA in clinic.

       

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