| Liver cancer is a serious and the most life threatening disease to human. It is highin malignancy but poor in prognosis, while its morbidity and mortality isincreasing year by year. According to the WHO, the number of annual increase ofliver cancer is626,000all over the world, of which55%occurred in china.Therefore, liver cancer diagnosis and treatment of the situation is very grim.In recent years, in situ imaging-guided tumor ablation plays an important role inthe clinical field of non-surgical treatment. Radio-frequency ablation（RFA）andpercutaneous ethanol injection (PEI) are two major ways of cancer treatment.Single needle RFA due to the impact of tumor structural or large tumor in the risk(close to the diaphragm, bile ducts, blood vessels and other importantorganizations), its treatment is less than ideal. In order to improve the therapeuticeffect of RFA, the use of anhydrous alcohol dehydration curing effect on theblood vessels of the tumor, the combination treatment of large tumors or specialsite of the tumor are the main research focuses of the current RFA. Previous studies mostly focuses on the time of using of RFA and PEI treatment of livercancer, but there is fewer quantitative analysis of relationship between RFAenergy and the amount of ethanol injection at the same time. The aim of researchis to study the use of RFA+PEI treatment in HCC, analyzing and observing theeffects of ultrasound-guided percutaneous ethanol injection efficiency and singleneedle RFA term efficacy of the treatment of liver cancer, tumor volume ofcoagulation necrosis of the size of the total energy of RFA and PEI relationshipbetween the injection volumePart1. Short-term efficacy of ultrasound-guided percutaneous ethanolinjection enhanced single needle radiofrequency ablation in treatment livercancerObjectiveTo investigate the short-term efficacy of ultrasound (US)-guided percutanousethanol injection enhanced single needle radiofrequency ablation (RFA) intreatment of liver cancer.MethodsSeventy-one patients with histological and two imaging parallel confirmedliver cancer were treated with RFA from June2010to June2011in XijingHospital. These patients were divided into RFA group (25patients,29lesions, themean diameter of tumors4.1cm) and RFA+PEI (radiofrequency ablation andpercutaneous ethanol injection) group (46patients,58lesions, the mean diameterof tumors4.3cm).ResultsThe volume of coagulated necrosis in RFA-PEI group was significantly largerthan that in RFA group (t=3.84599, P＜0.05). There was no operative mortalityand no serious complications occurred in both two groups. Two weeks after operation, the APF negative rate was not significantly different in both groups (X2=0.42, P>0.05)ConclusionsPercutaneous ethanol injection enables to increase the volume of coagulatednecrosis significantly and to reduce the energy requirement of routine RFA, as aresult it enhances single needle RFA efficacy. Part2. Dose-effect relationship between percutaneous ethanol injection andradiofrequency ablation in liver cancerObjectiveTo explore the dose-effect relationship between percutaneous ethanol injectionand radiofrequency ablation in liver cancer.MethodsForty-six patients (58lesions, the mean diameter of tumors4.3cm).Accordingto the average volume of alcohol injection,58lesions were divided into twogroups, which is high level injection volume (25lesions) group and low levelinjection volume (33lesions) group. According to the RFA average energy,58lesions were divided into two groups of high energy level (33lesions) group andlow energy level (25lesions)group.ResultsThe amount of ethanol injected into tumors positively correlated with thevolume of coagulated necrosis t=5.85714, r=0.615, P＜0.05) and it negativelycorrelated with treating efficacy (t=-7.52414, r=-0.709，P＞0.05). The amount ofaverage required energy positively correlated with the volume of coagulatednecrosis（t=14.13241, r=0.884，P＜0.05）, whereas no negatively significantcorrelation was admitted between the average amount of energy requirement and efficacy（t=-1.71673, r=-0.225，P＞0.05）.ConclusionsPEI in RFA ablation of the tumor, with the ablation volume increased, alcoholthan RFA may play a greater role. |
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