The Clinical Value Of Ultrasound-guided Microwave Ablation In The Treatment Of Primary Liver Cancer And The Effect Of Contrast-enhanced Ultrasound On Microwave Ablation

ObjectiveObjective To evaluate the clinical value of ultrasound-guided percutaneous microwave ablation in the treatment of primary liver cancer and the role of contrast-enhanced ultrasound in treatment.MethodsRetrospective analysis was performed on 76 patients with primary liver cancer treated in our hospital from August 2016 to September 2019,with a total of 82 lesions.In the surgery group,40 lesions in the operation group received surgical resection,while 42 lesions in the microwave ablation group received ultrasound-guided percutaneous microwave ablation.Changes of liver function,including serum alanine aminotransferase(ALT),serum aspartate aminotransferase(AST),serum total bilirubin(TBIL),cholinesterase(CHE),tumor markers(including alpha-fetoprotein(AFP)and serum carbohydrate antigen 19-9CA 19-9)were observed before and after treatment.Postoperative complications,including lung infection,bile leakage,skin incision infection and ascites or pleural effusion,were compared between the two groups.After treatment,the recurrence rate and the survival rate were compared between the two groups.One month after microwave ablation,CEUS,enhanced CT or enhanced MRI were used to assess the diagnostic accuracy of tumor inactivation rate.Results1.After one week after treatment,the levels of alanine aminotransferase,aspartate aminotransferase,TBIL and cholinesterase in the microwave ablation group were significantly lower than those in operation group(P<0.05).2.There was no significant difference in AFP and ca 19-9 levels between the two groups one month after treatment(P>0.05).3.The incidence of pulmonary infection,bile leakage,skin incision infection and ascites in the microwave ablation group was 2.7%,which was significantly lower than that in the control group(35.9%)(P<0.05).4.The recurrence rates of tumors in microwave ablation group at 3m,6m and 12 m were 2.4%,7.1% and 11.9%,respectively,and the recurrence rates in the operation group were 2.5%,5% and 10%,respectively.The tumor-free survival rates of 3m,6m and 12 m in the microwave ablation group were 97.6%,92.9% and 88.1%,respectively;the tumor-free survival rates of the operation group were 97.5%,95% and 90% in the same period;there were no statistically significant differences between the recurrence rates and the tumor-free survival rates of the two groups(P>0.05).5.After 1 month’s treatment,there was no statistical difference between CEUS and contrast-enhanced scanning.(P>0.05).ConclusionsUltrasound-guided percutaneous microwave ablation for primary liver cancer has less trauma,less damage to liver function,fewer complications,and the survival rate is similar to that of surgery,so it is worthy of clinical promotion.Contrast-enhanced ultrasound(CEUS)is very accurate in evaluating the therapeutic effect of microwave ablation,and has high clinical application value.