The Analysis Of The Clinical Efficacy Of RFA Treatment Of Liver Cancer

Objective: To explore factors that can influence the clinical effect of radiofrequency ablation(RFA) of liver cancer.Methods: 51 liver cancer cases that were treated with RFA were collected from cancer hospital between Jun. 2001 and Sept. 2005; liver biopsy was conducted with the help of ultrasound before RFA, HSP-70 expression was determined by POWERVISION^TM immunohistochemistry S-P method; all cases used RITA 1500 RFA machine: Power: 150W; Frequency: 460 kHz. The survival was followed up after the operation. The relationship among HSP-70 of live cancer, clinical classification of live cancer, inactive state of tumor, classification of live function, expression of AFP, tumor distribution and clinical effect of live cancer RFA were analyzed by SPSS11.5 statistical software.Results:1. The ratio of complete inactivation from 51 liver cancer cases treated with RAF is 54.9%(28 cases), while the ratio of partial inactivation is 45.1%(23 cases). The survival rate of complete inactivation after RFA in half a year, one year, two years and three years are 54.9%,31.3%,13.7% and 9.8% respectively. The survival rate of partial inactivation after RFA in half a year, one year, two years and three years are 41.1%,15.8%,9.8% and 0% respectively. The effect of complete inactivation is better than that of partial inactivation. The higher of tumor inactivation ratio, the better effect of RFA, P<0.05.2. HSP-70 positive expression index of 78.43% from 51 liver cancer patients is higher than 2. HSP-70 positive expression index of 46.7% from normal live tissue is higher than 2. The expression of HSP-70 in live cancer is higher than in normal live tissue, P<0.05. In 19 cases whose index of HSP-70 expression are less than 2, the survival rate are 100.0%, 47.37%, 36.84% and 15.79 respectively after RFA half year, one year, two years and three years; In 32 patients whose expression index is more than 2, the survival rate are 93.80%, 46.88%, 15.63% and 3.92% respectively after RFA half year, one year, two years and three years. The higher HSP-70 expression index, the worse the effect of RFA. There is relationship between the effect of RFA and The expression index of HSP-70.3. The survival rate of 41 liver cancer patients stagedⅡ-Ⅲwho were treated by RFA in half a year, one year, two years and three years are 80.3%,41.1%,23.5% and 9.8%, and survival rate of 10 liver cancer patients staged IV who were treated by RFA in half a year, one year, two years and three years are 15.6%,5.9%,0% and 0%. The higher of liver cancer clinical classification is, the worse of effect of RFA is, P<0.05.4. 37 patient with the tumor distributed in one hepatic segment, and 14 with the tumor distributed in multi-hepatic segments, the survival rate is unrelated with tumor distribution after treated with RFA half a year, one year, two years and three years, p<0.05.5. The expression of AFP in 7 patients is less than 20μg/L (except negative patients) , in 29 patients is between 20μg/L and 500μg/L, and in 15 patients is more than 500μg/L, the effect of RFA is getting worse as AFP gets higher, p<0.05.6. Liver function of 25 patients is A degree, of 25 patients is B degree and of 1 patient is C degree. Child-Pugh is related to the effect of RFA,p<0.05.Conclusion:1. RFA can be an additional therapy of liver cancer. RFA treatment can be chosen when the liver cancer patients have no indications of operation or the patient is not willing to operation.2. HSP-70 expression level of liver cancer, clinical classification of liver cancer, inactive state of tumor, classification of liver function, the expression of AFP are the factors that affect influence the clinical effect of RFA of liver cancer. Tumor distribution have no relationship with the effect of RFA of liver cancer. The effect of RFA of liver cancer can be predicted from HSP-70 expression level of liver cancer, clinical classification of liver cancer, inactive state of tumor, classification of liver function, the expression of AFP.