| Background: In recent years,the incidence and mortality rates of lung cancer are among the highest among malignancies worldwide.For early and intermediate stage lung cancer,radical resection of the primary lung lesion with systematic mediastinal lymph node dissection is the first choice of clinical treatment according to the current treatment protocol,however,only about 20-30% of patients can undergo surgery.Ablation is an effective treatment option for patients who are generally in poor health,have poor cardiopulmonary function,have multiple chronic underlying diseases,have clear contraindications to surgery or are subjectively fearful and financially constrained to undergo surgery.The local inactivation and control of tumours by various imageguided ablations,such as radiofrequency ablation,microwave ablation and cryoablation,has been proven to be effective in relevant trials.In recent years,microwave ablation is flourishing as a new product of technological innovation,and its efficiency and overall survival rate can even compete with that of surgery.Its high safety,low invasiveness and few complications have made it one of the most effective minimally invasive methods for the treatment of lung cancer.Microwave ablation refers to the killing of tumour cells by the power of microwave electromagnetic field,which causes various polar molecules inside the tumour to vibrate at different frequencies under the action of magnetic field,and then rub and collide with each other,generating high temperature of up to 60-150 degrees in a short period of time,and causing coagulative necrosis of tumour cells with the help of the generated high temperature.Objective: The aim of this study was to analyse the effectiveness and safety of CTguided microwave ablation in the treatment of pulmonary malignancies and to identify factors that affect the short-term efficacy and complications of MWA,and to explore the future of MWA in the treatment of pulmonary malignancies.Methods: In this study,data were collected on 50 patients attending the XXXX from January 2019 to June 2022.All patients underwent CT-guided microwave ablation.Baseline data such as age,gender,tumour diameter,tumour site,operation time,ablation energy,distance of the tumour from the pleura and pathological type were collected from the patients,and the corresponding statistical results were obtained by statistical analysis of the collected patient data,and the statistical results were analysed and studied to draw final conclusions.For the various basic data data collected from the patients,the Chinese version of SPSS 26.0 software was applied to process the data,and the tests such as chi-square test,t-test,rank sum test,fisher’s exact probability method and logistic regression analysis were reasonably used to process the data according to statistical norms,and the test standard was P < 0.05.Reuslts: After screening of the entry and exclusion criteria for this study,a total of 50 patients met the criteria and all underwent CT-guided microwave ablation.Among them,49 cases of MWA were successfully completed(49/50,98.00%),and the success rate of the procedure was 98.00%.3-month post-MWA outcome evaluation was CR:25(51.0%,23/49),PR:15(30.6%,15/49),SD:8(16.3%,8/49),and PD:1(2.0%,1/49).Efficacy rate = 81.6%,disease control rate = 97.9%.6-month post-MWA outcome evaluation CR:30(61.2%,30/49),PR:12(24.5%,12/49),SD:4(8.2%,4/49),PD: 3(6.1%,3/49).Efficacy rate = 85.7% and disease control rate = 93.9%.Univariate analysis was performed for each of the relevant factors that may have influenced the recent outcome,age(P=0.255),gender(P=0.154),tumour type(P=0.399),ablation position(P=0.481),total ablation energy(P=0.346),distance of the tumour from the pleura(P=0.768),presence of emphysema(P=0.641),duration of surgery(P= 0.123),and the presence of pneumothorax(P=0.549)were not statistically significant at P>0.05.Tumour diameter(P=0.001),presence or absence of solid component(P=0.037)P<0.05 were statistically significant.Bringing the factors that were significant in the univariate analysis into the ordered regression analysis yielded a statistically significant tumour diameter(P=0.007)P<0.05 and a positive correlation,i.e.the larger the tumour diameter the worse the recent outcome.Twelve cases(12/49,21.05%)had postoperative complications related to MWA,of which seven cases(14.2%,7/49)had serious complications,six of which were medium to large pneumothorax after WMA.The factors associated with the development of pneumothorax as a serious complication were analysed.A univariate analysis was performed for each factor likely to influence the development of pneumothorax complications after surgery: age(P=0.691),gender(P=1.000),tumour diameter(P=0.550),tumour location(P=1.000),tumour type(P=0.058),presence of solid components(P=1.000),ablation position(P=1.000),total ablation energy(P = 0.163),distance of the tumour from the pleura(P=0.550),P>0.05 was not statistically significant.The presence or absence of emphysema(P = 0.004)and time to surgery(P = 0.014),P<0.05 were statistically significant.When the results were included in the multi-factor logistic regression analysis,we obtained the following results: the presence or absence of emphysema(P=0.023)and the length of surgery(P=0.024),with P<0.05 being statistically significant,were independent risk factors for the development of postoperative pneumothorax complications,and the length of surgery and the presence or absence of emphysema were two positive factors for the development of pneumothorax as a serious complication,and the longer the length of surgery,the more likely the development of pneumothorax as a complication.The longer the duration of surgery,the greater the likelihood of pneumothorax;emphysema was also a major predictor of pneumothorax after microwave ablation.Conclusion: 1.MWA has definite recent efficacy in treating pulmonary malignant tumours,with high efficiency and disease control rate.2.MWA has high safety and few complications in the treatment of pulmonary malignancies.3.Tumour diameter is a relevant factor affecting the recent efficacy,the larger the tumour diameter,the worse the recent efficacy.4.Emphysema and duration of surgery were independent risk factors for complications of pneumothorax. |
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