重视病理性完全消融提高肝癌射频消融疗效.PDFVIP

·182· 述评 重视病理性完全消融提高肝癌 射频消融疗效 孙文兵 【提要】射频消融(RFA)已成为早期肝癌特别是肝细胞癌(HCC)潜在的治愈性手段。HCC的 病理特点是主癌灶周围存在范围不等的微静脉浸润(MVI)区和卫星灶。RFA时，对主癌灶行完全消 融，即便是有0．5～1．0cm的消融边界，获得的通常也只是影像学完全消融，残留的癌周MVI区和卫 星灶会导致肿瘤复发，影响疗效；而对包括主癌灶、MVI区和卫星灶在内的所有肿瘤组织行完全消 融，是病理性完全消融，可最大程度地预防肿瘤复发，这应该是RFA治疗HCC的理想目标。文章对 局部治疗视角下HCC临床病理特点、RFA治疗HCC的机制以及获得病理性完全消融的策略进行了 分析。 【关键词】肝细胞癌；射频消融； 完全消融}残留； 病理 The onthe of ablationinlivercancer of ablation importancepathologicalcomplete efficacyradiofrequency SUN Wen—bing．DepartmentofHepatobiliarySurgery，ChaoyangHospital，CapitalUniversityof Medical 100043，P．R．China Sciences，Beijing Correspondingauthor：SUN Wen—bing，Email：wb．sun@yahoo．corn．cn been utilizedasa curativetreat— [Abstract] ablation(RFA)has Radiofrequency widely potential ment for carcinoma(HCC)of ischaracter— modalityhepatocellular earlystage．Pathologically，HCC ized the microvascularinvasion(MVI)andsatellitelesionofvarious by peritumoral scope．Complete ablationofthemaintumor。evenwitha0．5——1．0emablative eom— margin，isusuallyonlyimaging ablationwithresidualofMVIandsatellitelesion。whichwill andaffectthe re— plete grow therapeutic suits．Whileablationofallthetumor themain MVIand complete tissue，includingtumor，peritumoral withno viabletumor satellitelesion。iSthe ablation residualof eell，which pathologicalcomplete shouldbethemain ofRFAforHCC．Thissummarizesthe characteris— target paper clinicopathological the ticsofHCCinthe