| Objective: To observe the feasibility,safety and short-term clinical efficacy of high intensity focused ultrasound(HIFU)in comparison with microwave ablation(MWA)in the treatment of metastatic small hepatocellular carcinoma,and to further explore its clinical application value.Methods: A retrospective study of the clinical data of 58 metastatic small hepatocellular carcinoma patients who received HIFU or MWA in Suining Central Hospital from January 2016 to December 2021.According to the different therapeutic methods,the 58 patients with metastatic small hepatocellular carcinoma were divided into two groups of HIFU with 28 cases and MWA with 30 cases.Then,the hospitalization cost,operation time,postoperative hospitalization time,tumor ablation,CEA value,AFP value,liver and kidney function changes and the incidence of postoperative complications of the patients were compared between the two groups.Results: A total of 58 patients with metastatic small hepatocellular carcinoma were included in this study,including 34 males and 24 females with an average age of60.07±11.57 years old.There were 28 patients in the HIFU group with a total of 42 metastatic lesions and 30 patients in the MWA group with a total of 48 metastatic lesions.According to the analysis of the general data of the two groups,including age,sex,body mass index,Child-Pugh grade of liver function,ALT,AST,albumin,creatinine,total number of tumors,tumor diameter,tumor source,CEA,AFP,etc.,it was found that there were no significant statistical differences(P > 0.05).Local ablation was successfully performed in both groups(100%).The average hospitalization costs were 14.1±4.5 thousand Yuan and 16.5±2.8 thousand Yuan,and the operation time were 122.96±55.41 min and 52.26±11.86 min for HIFU group and MWA group,respectively.The difference was statistically significant(P<0.05).The postoperative hospital stay was 4(3,8)days for HIFU group and 4(3,5)days for MWA group,with no significant statistical difference(P>0.05).The tumor ablation rates after operation were 83.33%(35/42)and 85.42%(41/48)with clinical effective rates of 89.28%(25/28)and 90.00%(27/30)and clinical control rates of 96.43%(27/28)and 90.00%(27/30)for HIFU group and MWA group respectively,with out significant statistical difference(P>0.05).The values of CEA and AFP in HIFU group and MWA group after ablation were lower than those before ablation,in which the value of CEA decreased significantly(P < 0.05),but AFP did not(P > 0.05).The CEA value decline rates were 81.25% and70.00% and the AFP value decline rates were 57.14% and 75.00% for HIFU group and MWA group respectively,and there was no significant statistical difference between the two groups(P>0.05).After the local ablation,15 patients(53.57%)in the HIFU group and 5 patients(16.67%)in the MWA group had tissue damage in skin,and the difference was statistically significant between the two groups(P<0.05).There was no significant statistical difference in other complications,such as fever,postoperative pain,functional impairment in liver,bile leakage and others between the two groups(P>0.05).Conclusion: HIFU is a safe and feasible method for the treatment of metastatic small hepatocellular carcinoma,which can achieve full ablation of tumor cells,Compared with MWA,HIFU resulted in lower hospitalization cost,lesser trauma and fewer postoperative complications for patients,therefore,it is promising as a new option for local ablative treatment of metastatic hepatocellular carcinoma. |
PDF Full Text Request