| China has almost the highest incidence of PHC of the world, so how to improve the level of the diagnosis and treatment of PHC is very important to china. PRFA is a new curative method of PHC which was put into clinical practice only a few years ago. Then the therapeutic evaluation of PRFA to PHC is necessary. Following is the therapeutic evaluation of PRFA to 46 non-operation and non-TACE prime small PHC. Method: 46 PHC patients were pick out of 160 patients who have had PRFA in our hospital during June 2000 to June 2003. All the 46 patients are confined by following: (1) The diagnosis of PHC was confirmed by ultrasonic,CT scan and pathology; (2) All had the indication of PRFA; (3) The diameter of tumour tissue was less than 5cm; (4) Without portal cancer plug or distant metastasis; (5) All did not have operation or other curative methods of PHC before PRFA. All the 46 patients were divided into two groups according to the diameter of the tumour tissue, one group is between 3-5 cm, the other is less than 3 cm. After PRFA we observe the following: (1) The patients symptoms and signs; (2) Detect the ablation of the tumour tissue by ultrasonic and contract enhanced CT scan; (3) Detect the serum AFP concentration; (4) Detect the alteration of the liver function; (5) Detect the complications of PRFA. Result: (1) The patients symptoms and signs: Almost all patients had temporary hepatic area pain. The previous symptoms such as hypodynamia and anorexia were got relief after PRFA. The signs of cirrhosis remained. (2) Ablation of the tumour tissue: In all 46 patients there were 37 patients' tumour tissue were thoroughly ablated, which was confirmed buy ultrasonic and contract enhanced CT scan. The ablation rate of all the 46 patients was 80.4%. In the group of less than 3cm the ablation rate was 87.5% (21/24), in the group of 3-5 cm the ablation rate was 72.7% (16/22). There is no significant difference between the two groups as the ablation rate is concerned (p>0.05). Reexamination of contrast enhanced CT scan one month after PRFA we found the diameter of the tumour tissue had no significantly reduced contrast to previous, but the CT data of the tumour tissue reduced significantly contrast to previous (p<0.05). (3) The serum AFP concentration: In all 46 patients there were 36 AFP positive patients, the positive rate of AFP was 78.3%. After PRFA there were 29 patients' serum AFP concentration reduced to normal, the percentage of AFP conversion patients was 80.6%. In the group of less than 3cm there were 19 AFP positive patients before PRFA, and 17 patients' serum AFP reduced to normal after PRFA, the percentage of AFP conversion patients was 89.5%. In the group of 3-5cm there were 17 AFP positive patients before PRFA, and 12 patients' serum AFP reduced to normal after PRFA, the percentage of AFP conversion patients was 70.6%. There is no significant difference between the two groups as the percentage of AFP conversion patients is concerned (p<0.05). The serum AFP usually reduced to normal two months after PRFA. (4) The alteration of the liver function: After PRFA almost all patients' liver function exacerbated temporarily, such as ALT,AST,TBIL increased and ALB,CHE decreased. After corresponding treatment the liver function recovered to the level of previous about two weeks later. (5) The complications of PRFA: In the course of PRFA all patients felt hepatic area pain that could disappear within few days. Almost all patients had a fever within 3 days after PRFA and patients' body temperature was usually blow 38.5℃. Almost all patients had temporary alteration in liver function. 8 patients had ascites after PRFA because of the alteration of the liver function. 3 patients had little bleeding under the hepatic capsule. 2 patients had melena. Discussion: Following is the principle of PRFA: Because of the variation of the tumour cells' gene and function, the tumourous vessel has deficiency in physiological regulation, so the tumour tissue is not so resistant to fever as normal tissue...
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