Comparison Of Clinical Effects Between Nanosecond Pulse And Radiofrequency Ablation In The Treatment Of Hepatocellular Carcinoma Near Dangerous Zone

Objective: To compare the clinical efficacy of ultrasound-guided Nanosecond Pulsed Electric Field(ns PEF)and Radiofrequency ablation(RFA)in the treatment of hepatocellular carcinoma near dangerous zone.Methods: Collect data of hepatocellular carcinoma patients treated with ablation in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2021.According to inclusion criteria and exclusion criteria,12 patients who underwent nanosecond pulse divided into ns PEF group and 47 patients who underwent radiofrequency ablation divided into RFA group.The perioperative data and postoperative follow-up data were compared between the two groups.Continuous variables were analysed using Independent-samples T test if the assumption of normality was satisfied,continuous variables were analysed using rank sum test if the assumption of normality was unsatisfied,and categorical variables were analysed using the χ~2 test or Fisher exact test.Recurrence-free survival(RFS)and Overall Survival(OS)curves were constructed using the Kaplan-Meier method and compared using the log-rank test.Results: There was no remarkable difference in preoperative basic information between the RFA group and the ns PEF group.The incidence of minor complications and total complications in ns PEF group was lower than RFA group,and the difference was statistically significant.(χ~2=4.71 P= 0.030<0.05,χ~2=9.76 P=0.002<0.05).There was no remarkable difference in the incidence of major complications between ns PEF group and RFA group(χ~2=0.41 P=0.904).The operation time of ns PEF group was longer than RFA group,and the difference was statistically significant.(t =-6.91 P=0.091<0.05).AST indexes in RFA group were higher than ns PEF group on the three to seven days after surgery,and the difference was statistically significant(t =3.23P=0.033<0.05).Although the recurrence rate of one month,three months and six months after surgery in ns PEF group was significantly lower than that in RFA group,the difference was not statistically significant.There was no significant difference in AFP at one month、three months and six months after operation.There was no significant difference in the overall survival time and the median recurrence-free survival time between the ns PEF and RFA group.Conclusion: Compared with radiofrequency ablation,nanosecond pulse ablation is a safer and more effective treatment for HCC near dangerous zone.