小肝细胞癌超声声像图与射频消融预后关系研究

Study on correlation between ultrasonography and prognosis of radiofrequency ablation in SHCC

摘要:

目的研究小肝细胞癌（SHCC）B 超分类与射频消融（RFA）预后相关性。方法回顾性分析2006 年1 月-2010 年12 月在该院接受RFA治疗的SHCC 患者97 例。根据超声影像图，将患者分为两类：1 型，有晕征（n =29）；2 型，无晕征（n =68）。2 型进一步分为3 个亚型：2a型，均匀高回声（n =9）；2b 型，低回声，边缘平滑（n =43）；2c型（ n=16），低回声，边缘不规则或不清晰。由于病例数量小，该研究将2a 型SHCC 患者排除在外。结果2b 型、1 型和2c 型患者2 年复发率分别为26%、42%和69%，2b 型和2c 型（P =0.008），以及1 型和2c 型（P =0.005）差异有统计学意义。2b 型、1 型和2c型患者5 年生存率分别为89%、43%和65%。2b 型生存时间长于其他类型（P 1 型和2b 型=0.009； P2b 型和2c 型=0.008）。多因素分析表明B超分型是与无复发生存率（P =0.027）和生存（P =0.003）均独立相关的变量。结论SHCC B超分型是RFA 预后的预测因子。

Abstract:

Objective To study the correlation between ultrasonography and prognosis of radiofrequency ab- lation (RFA) in hepatocellular carcinoma (SHCC). Methods A total of 97 cases of SHCC with RFA were included in a retrospective analysis from January 2006 to December 2010. Patients were divided into 2 types according to ultrasound images: type 1, with halo sign (n = 29); type 2, without halo sigh ( n= 68). Type 2 was further categorized into three subgroups: type 2a, homogenous hyperecho (n = 9); type 2b, hypoecho with smooth margins (n = 43); and type 2c (n = 16), hypoecho with irregular or unclear margins. Patients with type 2a SHCC were excluded due to the small number of cases. Results Two-year recurrence rates for type 2b,type 1 and type 2c were 26%, 42% and 69%, respectively, with significant differences between type 2b and type 2c (P = 0.008), and between type 1 and type 2c (P = 0.005). Five-year survival rates were 89%, 43% and 65%, respectively. Survival time of type 2b was significantly longer than that of other types (type 1 vs type 2b, P= 0.009; type 2b vs type 2c,P = 0.008). Multivariate analysis identified that ultrasound classification was independent of recurrence (P = 0.027) and survival (P = 0.003). Conclusion B-mode ultrasound classification of SHCC is a predictive factor of prognosis of RFA.