| OBJECTIVE To detect the relationship between the injection quantity of absolute ethanol (diffusing area of absolute ethanol) as well as the interval and the forming of fibreboard along with the curative effect in the treatment of hepatic carcinoma and to evaluate the clinical application value of percutaneous hepatic quantified ethanol injection (PHQEI) in the treatment of hepatic carcinoma (HCC). METHODS ⑴ Experimental study: Twenty-four human hepatic carcinoma SMMC-7721 xenografted nude mice were randomly divided into three groups, which were group A injected with quantified ethanol at short interval (QESI), group B with quantified ethanol at long interval (QELI) and group C with small quantity of ethanol (half quantity of ethanol as used in the QESI) at long interval (SQLI). Each group contained 8 mice. Ten days after the transplantation the absolute ethanol was injected into the tumors of all the nude mice. The ethanol was injected into the tumors of the mice of the QESI group every 3 days. The tumors of both QELI and SQLI groups were injected every 7 days. All the mice were injected twice. Five days after the second injection the nude mice were killed. The tumor tissue was sent for pathologic histology and electron microscope examination. The three diameters of the tumors were measured with high frequency ultrasound before and after the therapies and the tumor growth index (TGI) was calculated. The experiment was carried out with the double blind method. ⑵ Clinical study: PHQEI group: The tumors in 141 cases of pathologic proved HCC were injected ethanol guided by ultrasound every 2-3 days for 4-10 times per period of treatment. The quantity of ethanol was calculated according to the regressive equations which were Y=2.885X when the mass was≤5cm in diameter and Y=1.805X when the mass was >5cm in diameter (X is the maximal diameter of the mass with the unit cm, Y is the ethanol quantity with the unit ml). The tumors could also be injected for 10-20 times per period of treatment when it was >5cm in diameter. Percutaneous hepatic non-quantified ethanol injection (PHNQEI) group: The tumors in 62 cases of pathologic proved HCC were injected ethanol guided by ultrasound every 3-5 days for 4-10 times per period of treatment. The quantity of ethanol was calculated according to the formulas which were quantity(ml)= diameter(cm)+1 (when the diameter≤5cm) and quantity(ml)= diameter (cm)+2 (when the diameter>5cm). The follow-up period lasted 12-60 months. The survival rates of 1-5 years of each group and the recurrent rates in situ as well as dystopia in the liver of PHQEI group were calculated. RESULTS ⑴ Experimental studies: The TGI of QESI group (0.072±0.018) and QELI group (0.094±0.028) were apparently lower than that of SQLI group (1.982±0.482) (P<0.01). The TGI of QESI group seemed to be lower than that of QELI group, but they were not different markedly (P>0.05). The severe degeneration and necrosis could be seen in QESI group under the pathologic histology examination. The necrosis areas of SQLI group were all less than 80%. Coagulate necrosis could be seen in most tumors of QESI group and there was no residuary cancer cells in sight under electronic microscope, while the residuary cancer and inflammation cells and fibre tissues could be seen around the tumors of QELI group. In SQLI group the cancer cells grew luxuriantly in the periphery of the tumor. The infiltration of the inflammation cells could be seen and the fibre tissues formed. ⑵ Clinical study: The survival rates of 1-5 years of PHQEI group were 91.5%, 79.7%, 66.4%, 58.3% and 46.6%, markedly higher than those of PHNQEI group which were 83.9%, 69.4%, 49.1%, 44.0% and 22.0%(P<0.05). In PHQEI group the survival rates of 1-5 years of the cases of tumors ≤3cm in diameter were 94.7%,86.0%,80.1%,66.0% and 59.4% respectively, higher than those of the cases of tumors >3cm in diameter, which were 90.0%,83.1%,64.2%,55.0% and 36.9% respectively. In PHQEI group the recurrent rates of the tumors in situ and in dystopia of the c...
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