Short-term Efficacy Of Transcatheter Arterial Embolization Combined With High-intensity Focused Ultrasound In Treatment Of Early Hepatic Carcinoma And The Risk Factors Of Relapse

Objective: To explore the hepatic arterial embolization combined with short-term effect of high intensity focused ultrasound treatment of early hepatic carcinoma, and identify what factors are risk factors for recurrence after the treatment.Methods: From Jan 2013 to Mar 2015, a total of 39 HCC patients who were treated in HIFU treatment center of second Affiliated Hospital of Chongqing Medical University. TNM stage T1~2N0M0. All patients were treated by TAE, and were treaed by HIFU after 1-2 weeks. The TAE using the conventional method of the Blue Shield, Second Affiliated Hospital of Chongqing Medical University, which is inserted catheter from the femoral artery, the blood vessel injection of contrast agent development, selectively chemoembolization agent into the tumor feeding arteries, the blood supply to it interruption or reduction to cause tumor necrosis. HIFU treatment using the JC type focused ultrasound tumor therapy system(China Chongqing HIFU Technology Co.,Ltd.), under the general anesthesia, using ultrasonic real-time monitoring system located exactly liver lesions, focused ultrasound to kill tumors by thermal effects, cavitation and mechanical effects cell.The clinical data of these patients were retrospectively reviewed, including: age, tumor size, the location of the tumor(proximity to large vessels, gallbladder, diaphragm), preoperative albumin, HBV-DNA content, preoperative and postoperative serum AFP, complications, and calculate the rate of surgical ablation of tumor size by preoperative and postoperative MRI showed, changes in the preoperative and postoperative AFP, complications, and calculation HIFU ablation rate and after 3 months of treatment the tumor by tumor size reduction rate before and after treatment and the MRI showed 3 months later. According to comparing the changes between the before and after treatment in AFP, HIFU ablation rates, complications after treatment, 3 months after tumor shrinkage rate, to analysis the efficacy and the risk factors for recurrence. Comparative data before and after treatment using t-test. Which were compared using Fisher’s exact test data classification, multivariate analysis is constructed multivariate logistic regression model. P <0.05 was considered statistically significant. All statistical analyzes were performed using SPSS19.0 software Bian.Result:(1)In these 39 patients, the elevated serum AFP decreased to varying degrees. After the treatment, the MRI showed a apparent coagulation necrosis area in the original lesions area, the vast majority of tumor ablation rate of more than 90% after treatment. After 3 months of treatment, the MRI showed the vast majority of tumors have different degrees of narrowing. All patients were no serious complications.(2)Wherein the tumor adjacent to large blood vessels or gallbladder, diaphragm and HBV-DNA quantitative> 1 × 103 IU / ml in patients with higher risk of recurrence within 1 year(p <0.05), and age, tumor size, albumin, AFP levels and relapse no statistical significance between(p> 0.05). Multivariate analysis showed that serum AFP level and HBV-DNA quantification and treatment of recurrence, p <0.05, statistically significant relapse no correlation(p after treatment with other factors> 0.05).Conclusion: TAE combined with HIFU is effective and feasible in treatment of early liver cancer, and the tumor location(proximity to large vessels, gallbladder, diaphragm) and the HBV-DNA copy number is an independent risk factor for relapse after treatment, and pre-treatment serum AFP levels are not independent risk factor for recurrence.