Comparison of efficacy and prognosis of ultrasound-guided and CT-guided radiofrequency ablation in the treatment of patients with hepatocellular carcinoma

doi:10.3877/cma.j.issn.2095-2015.2024.02.010

Abstract

Abstract:

Objective

To explore the effects of ultrasound-guided and CT-guided radiofrequency ablation (RFA) on serum alpha-fetoprotein (AFP), transferrin (TRF) and prognosis in patients with hepatocellular carcinoma.

Methods

A total of 89 patients with hepatocellular carcinoma undergoing RFA in Yulin Red Cross Hospital were enrolled as the research objects between September 2015 and September 2019, including 45 cases undergoing ultrasound-guided RFA in ultrasound group and 44 cases undergoing CT-guided RFA in CT group. The perioperative data in the two groups were recorded. AFP and TRF levels were detected. All patients were followed up regularly for 36 months. The survival curves were drawn by Kaplan-Meier method to compare prognosis in the two groups.

Results

The complete ablation rate in CT group was higher than that in ultrasound group, ablation frequency was higher than that in ultrasound group, and ablation time was longer than that in ultrasound group, with statistically significant differences (P<0.05). After surgery, recurrence rate and local recurrence rate in ultrasound group were 31.1% and 20.0%, significantly higher than those in CT group (13.6%, 4.6%), with statistically significant differences (P<0.05). After surgery, the levels of AFP and TRF in both groups were decreased, which were lower in CT group than ultrasound group, with statistically significant differences (P<0.05). At 3 years after surgery, progression-free survival rate in CT group was significantly higher than that in ultrasound group [84.1% (37/44) vs. 46.7% (21/45)], with a statistically significant difference (P<0.05).

Conclusion

Curative effect of CT-guided RFA is significant on hepatocellular carcinoma, which can increase survival rate. The mechanism may be significantly related to reducing AFP and TRF levels.

Key words: Hepatocellular carcinoma, Radiofrequency ablation, Ultrasonic guidance, Computer tomography guidance, Alpha-fetoprotein, Transferrin

Peng Mo, Xingchun Guo, Xiujuan Liang, Yaoming Wang. Comparison of efficacy and prognosis of ultrasound-guided and CT-guided radiofrequency ablation in the treatment of patients with hepatocellular carcinoma[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(02): 151-154.

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References 17

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组别	例数	完全消融[例(%)]	消融次数(次,±s)	消融时间(min,±s)	术后住院时间(d,±s)
超声组	45	39(86.7)	1.2±0.2	28.9±3.6	1.0±0.2
CT组	44	44(100.0)	1.9±0.3	45.2±6.9	0.9±0.2
χ²/t值		6.291	12.979	14.017	1.415
P值		0.012	<0.001	<0.001	0.161

组别	例数	完全消融[例(%)]	消融次数(次,±s)	消融时间(min,±s)	术后住院时间(d,±s)
超声组	45	39(86.7)	1.2±0.2	28.9±3.6	1.0±0.2
CT组	44	44(100.0)	1.9±0.3	45.2±6.9	0.9±0.2
χ²/t值		6.291	12.979	14.017	1.415
P值		0.012	<0.001	<0.001	0.161

组别	例数	AFP(ng/mL)		TRF(g/L)
组别	例数	术前	术后	术前	术后
超声组	45	475.3±59.4	172.9±21.6^a	7.9±1.0	5.7±0.7^a
CT组	44	465.1±58.1	131.6±16.5^a	8.1±1.1	4.3±0.5^a
t值		0.819	10.120	0.898	10.836
P值		0.415	<0.001	0.372	<0.001

组别	例数	AFP(ng/mL)		TRF(g/L)
组别	例数	术前	术后	术前	术后
超声组	45	475.3±59.4	172.9±21.6^a	7.9±1.0	5.7±0.7^a
CT组	44	465.1±58.1	131.6±16.5^a	8.1±1.1	4.3±0.5^a
t值		0.819	10.120	0.898	10.836
P值		0.415	<0.001	0.372	<0.001

因素	单因素分析				多因素分析
因素	β	HR	95% CI	P	β	HR	95% CI	P
术后AFP	0.497	1.644	1.139~2.371	0.008	0.802	2.230	1.469~3.385	<0.001
术后TRF	0.518	1.679	1.164~2.422	0.006	0.521	1.684	1.287~2.202	<0.001

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