AIM:To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer.
METHODS:A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group (n = 56, 65 tumors) and 64-slice group (n = 8, 77 tumors). All patients were accepted and received targeted therapy by an argon-helium superconducting surgery system. The guided scan times of the two groups was recorded and compared. In the two groups, the lesion ice coverage in diameter of ≥ 3 cm and < 3 cm were recorded, and freezing effective rate was compared. Hepatic perfusion values [hepatic artery perfusion (HAP), portal vein perfusion (PVP), and the hepatic arterial perfusion index (HAPI)] of tumor tissues, adjacent tissues and normal liver tissues at preoperative and postoperative four weeks in the two groups were compared. Local tumor changes were recorded and efficiency was compared at four weeks post-operation. Adverse events were recorded and compared between the two groups, including fever, pain, frostbite, nausea, vomiting, pleural effusion and abdominal bleeding.
RESULTS:Guided scan times in the dual-slice group was longer than that in the 64-slice group (t = 11.445, P = 0.000). The freezing effective rate for tumors < 3 cm in diameter in the dual-slice group (81.58%) was lower than that in the 64-slice group (92.86%) (χ2 = 5.707, P = 0.017). The HAP and HAPI of tumor tissues were lower at four weeks post-treatment than at pre-treatment in both groups (all P < 0.05), and those in the 64-slice group were lower than that in the dual-slice group (all P < 0.05). HAP and PVP were lower and HAPI was higher in tumor adjacent tissues at post-treatment than at pre-treatment (all P < 0.05). Furthermore, the treatment effect and therapeutic efficacy in the dual-slice group were lower than the 64-slice group at four weeks post-treatment (all P < 0.05). Moreover, pleural effusion and intraperitoneal hemorrhage occurred in patients in the dual-slice group, while no complications occurred in the 64-slice group (all P < 0.05).
CONCLUSION:64-slice spiral CT applied with cryoablation in targeted therapy for liver cancer can achieve a safe and effective freezing treatment, so it is worth being used.
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【Observation of the effect of targeted therapy of 64-slice spiral CT combined with cryoablation for liver cancer.].
【64层螺旋CT联合冷冻消融靶向治疗肝癌的疗效观察。】
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DOI：10.3748/wjg.v23.i22.4080文章类型：杂志文章
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目的：观察64层螺旋CT和冷冻消融联合靶向治疗肝癌的效果。
方法：本研究共纳入124例患者（142个肿瘤）。根据使用双层螺旋CT或64层螺旋CT的指导技术，将患者分为两组：双层组（n = 56，65个肿瘤）和64层组（n = 8， 77个肿瘤）。所有患者均接受了氩氦超导手术系统的靶向治疗。记录并比较两组的指导扫描时间。两组均记录直径≥3 cm和<3 cm的病变冰覆盖率，并比较冷冻有效率。比较两组患者术前和术后4周的肿瘤组织，邻近组织和正常肝组织的肝灌注值[肝动脉灌注（HAP），门静脉灌注（PVP）和肝动脉灌注指数（HAPI）]。 。记录局部肿瘤变化，并在术后四周比较效率。记录并比较两组的不良事件，包括发烧，疼痛，冻伤，恶心，呕吐，胸腔积液和腹腔出血。
结果：双切片组的指导扫描时间比64切片组的指导扫描时间更长（t = 11.445，P = 0.000）。双切片组对直径<3 cm的肿瘤的冷冻有效率（81.58％）低于64切片组的冷冻有效率（92.86％）（χ2= 5.707，P = 0.017）。两组在治疗后4周的肿瘤组织HAP和HAPI均低于治疗前（均P <0.05），而64层组的肿瘤组织的HAP和HAPI均低于双层组（均P <0.05）。 P <0.05）。与治疗前相比，治疗后肿瘤邻近组织中的HAP和PVP较低，而HAPI较高（所有P <0.05）。此外，在治疗后4周，双切片组的治疗效果和疗效均低于64切片组（所有P <0.05）。此外，双排组患者发生胸腔积液和腹膜内出血，而64排组患者未发生并发症（所有P <0.05）。
结论：64层螺旋CT联合冷冻消融术在肝癌靶向治疗中可达到安全有效的冷冻治疗，值得推广。
方法：本研究共纳入124例患者（142个肿瘤）。根据使用双层螺旋CT或64层螺旋CT的指导技术，将患者分为两组：双层组（n = 56，65个肿瘤）和64层组（n = 8， 77个肿瘤）。所有患者均接受了氩氦超导手术系统的靶向治疗。记录并比较两组的指导扫描时间。两组均记录直径≥3 cm和<3 cm的病变冰覆盖率，并比较冷冻有效率。比较两组患者术前和术后4周的肿瘤组织，邻近组织和正常肝组织的肝灌注值[肝动脉灌注（HAP），门静脉灌注（PVP）和肝动脉灌注指数（HAPI）]。 。记录局部肿瘤变化，并在术后四周比较效率。记录并比较两组的不良事件，包括发烧，疼痛，冻伤，恶心，呕吐，胸腔积液和腹腔出血。
结果：双切片组的指导扫描时间比64切片组的指导扫描时间更长（t = 11.445，P = 0.000）。双切片组对直径<3 cm的肿瘤的冷冻有效率（81.58％）低于64切片组的冷冻有效率（92.86％）（χ2= 5.707，P = 0.017）。两组在治疗后4周的肿瘤组织HAP和HAPI均低于治疗前（均P <0.05），而64层组的肿瘤组织的HAP和HAPI均低于双层组（均P <0.05）。 P <0.05）。与治疗前相比，治疗后肿瘤邻近组织中的HAP和PVP较低，而HAPI较高（所有P <0.05）。此外，在治疗后4周，双切片组的治疗效果和疗效均低于64切片组（所有P <0.05）。此外，双排组患者发生胸腔积液和腹膜内出血，而64排组患者未发生并发症（所有P <0.05）。
结论：64层螺旋CT联合冷冻消融术在肝癌靶向治疗中可达到安全有效的冷冻治疗，值得推广。
