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| 1 | 氩氦刀冷冻消融治疗原发性肝癌的临床研究显示文摘[目的]探讨氩氦刀冷冻消融综合治疗中晚期肝癌的疗效。[方法]96例中晚期原发性肝癌分3组观察。第一组用氩氦刀冷冻消融联合TACE治疗37例;第二组单纯用氩氦刀冷冻消融32例;第三组单纯用TACE27例。氩氦刀冷冻消融采用B超/或CT引导经皮穿刺肝肿瘤,共计对97个病灶使用203把氩氦刀二次循环冷冻。[结果]氩氦刀冷冻术后有94.2%(65/69)的患者精神状态得到改善,腹部疼痛症状减轻,恢复快。氩氦刀超低温冷冻联合TACE的近期疗效和12、24个月的生存率明显优于另外两组,中位生存期延长(P<0.05)。[结论]氩氦刀联合TACE是治疗肝癌有效的方法之一,可望提高肝癌患者生存期和改善生命质量,为丧失手术机会的晚期肝肿瘤患者开辟了一条新的治疗途径。 | 聂舟山 冯华松 温居一 张新红 韩志海 李泳群 孟激光 李毅 段蕴铀 | 2008 | 中国肿瘤2008，17，5： | 22 |
| 2 | Percutaneous cryosurgery for the treatment of hepatic colorectal metastases显示文摘AIM:To determine the safety and efficacy of efficacy of percutaneous cryosurgery for treatment of patients with hepatic colorectal metastases. METHODS: Three hundred and twenty-six patients with non-resectable hepatic colorectal metastases underwent percutaneous cryosurgery under the guidance of ultrasound or CT. Follow-up was 1 mo after cryosurgery and then every 4 mo thereafter by assessment of tumor markers, liver ultrasonography, and abdominal CT. For lesions suspicious of recurrence, a liver biopsy was performed and subsequent repeat cryosurgery was given if histology was positive for cancer. RESULTS: All patients underwent a total of 526 procedures of cryosurgery. There were 151 patients who underwent repeat procedures of cryosurgery for recurrent tumors in the liver and extrahepatic places. At 3 mo after cryosurgery, carcinoembryonic antigen (CEA) levels in 197 (77.5%) patients who had elevated markers before cryosurgery decreased to normal range. Among 280 patients who received CT following-up, cryotreated lesions showed complete response (CR) in 41 patients (14.6%), partial response (PR) in 115 patients (41.1%), stable disease (SD) in 68 patients (24.3%) and progressive disease (PD) in 56 patients (20%). The recurrence rate was 47.2% during a median follow-up of 32 mo (range, 7-61). Sixty one percent of the recurrences were seen in liver only and 13.9% in liver and extrahepatic areas. The recurrence rate at cryotreated site was only 6.4% for all cases. During a median follow-up of 36 mo (7-62 mo), the median survival of all patient was 29 mo (range 3-62 mo). Overall survival was 78%, 62%, 41%, 34% and 23% at 1, 2, 3, 4 and 5 years, respectively, after the treatment. Patients with tumor size less than 3 cm, tumor in right lobe of liver, lower CEA levels (< 100 ng/dL) and post- cryosurgery TACE had higher survival rate. There wasno significant difference in terms of survival based on the number of tumors, pre-cryosurgery chemotherapy and the timing of the development of metastases (synchronous vs metachronous). Patients who underwent 2-3 procedures of cryosurgery had increased survival compared to patients who received cryosurgery once only. There was no intra-cryosurgery mortality. Main adverse effects, such as hepatic bleeding, cryoshock, biliary fistula, liver failure, renal insufficiency and liver abscess were only observed in 0.3%-1.5% of patients. CONCLUSION:Percutaneous cryosurgery was a safe modality for hepatic colorectal metastases. Rather than an alternative to resection, this technique should be regarded as a complement to hepatectomy and as an additional means of achieving tumor eradication when total excision is not possible. | Ke-Cheng Xu Li-Zhi Niu Wei-Bing He Yi-Zi Hu Jian-Sheng Zuo | 2008 | World Journal of Gastroenterology2008，14，9： | 19 |
| 3 | Sequential use of transarterial chemoembolization and percutaneous cryosurgery for hepatocellular carcinoma显示文摘AIM: To evaluate the efficacy of sequential use of transarterial chemoembolization (TACE) and percutaneous cryosurgery for unresectable hepatocellular carcinoma (HCC). METHODS: Four hundred and twenty patients were enrolled in this study. The patients, who were considered to have unresectable tumors due to their location or size or comorbidity, were divided into sequential TACE-cryosurgery (sequential) group (n = 290) and cryosurgery alone (cryoalone) group (n = 130). Patients in the sequential group tended to have larger tumors and a greater number of tumors than those in the cryo-alone group. Tumors larger than 10 cm in diameter were only seen in the sequential group. TACE was performed with the routine technique and percutaneous cryosurgery was conducted under the guidance of ultrasound 2-4 wk after TACE. RESULTS: During a mean follow-up period of 42 ± 17 mo (range, 24-70 mo), the local recurrence rateat the ablated area was 17% for all patients, 11% and 23% for patients in sequential group and cryoalone groups, respectively (P = 0.001). The overall 1-, 2-, 3-, 4and 5-year survival rate was 72%, 57%, 47%, 39% and 31%, respectively. The 1and 2-year survival rates (71% and 61%) in sequential group were similar to those (73% and 54%) in cryo-alone group (P = 0.69 and 0.147), while the 4and 5-year survival rates were 49% and 39% in sequential group, higher than those (29% and 23%) in cryo-alone group (P = 0.001). Eighteen patients with large HCC (> 5 cm in diameter) survived for more than 5 years after sequential TACE while no patient with large HCC (> 5 cm in diameter) survived more than 5 years after cryosurgery. The overall complication rate was 24%, and the complication rates were 21% and 26% for the sequential and cryo-alone groups, respectively (P = 0.06). The incidence of hepatic bleeding was higher in cryo-alone group than in sequential group (P = 0.02). Liver crack only occurred in two patients of the cryoalone group. CONCLUSION: Pre-cryosurgical TACE can increase the cryoablation efficacy and decrease its adverse effects, especially bleeding. Sequential TACE and cryosurgery may be the better procedure for unresectable HCC, especially for large HCC. | Ke-Cheng Xu Li-Zhi Niu Qiang Zhou Yi-Ze Hu De-Hong Guo Zheng-Ping Liu Bing Lan Feng Mu Ying-Fei Li Jian-Sheng Zuo | 2009 | World Journal of Gastroenterology2009，15，29： | 13 |
| 4 | 氩氦刀治疗肝癌的研究进展显示文摘冷冻消融对于肝癌或转移性肝癌患者而言,是一种安全、有效、微创的方式。氩氮刀是一种微创消融技术,在CT、B超或MRI引导下进行能够完全有效地摧毁肿瘤细胞组织。目前氩氦刀已单独或联合其他方法广泛用于肝癌的治疗。本文就氩氦刀的临床使用、治疗进展及并发症等予以综述。 | 徐苏琴 杨茂江 严静 胡兰 徐晓雪 | 2017 | 西部医学2017，29，3： | 13 |
| 5 | 超声和CT引导下氩氦刀冷冻治疗恶性肿瘤的临床应用显示文摘目的探讨超声和CT引导下氩氦刀冷冻治疗恶性肿瘤的临床应用价值。方法无法手术切除或不愿手术切除的恶性肿瘤患者45例49个病灶,在超声或CT引导下进行氩氦刀冷冻治疗,肿瘤分为≤3cm和>3cm两组,观察术中冰球形成和冰球覆盖病灶率、术后病理变化和病灶缩小率。结果87.5%的冰球在冷冻开始后50s内形成,声像图表现为横断面上靶区内的弧形强光带后方伴声影,纵断面上靶区内“成角凸起”的强光带后伴声影。随着复温,强光带消失,冷冻区呈不均匀高回声;CT扫描,冷冻消融区为类圆形的低密度区。治疗后组织病理学可见细胞浆疏松、空泡样改变、细胞核固缩、核浓染、核碎裂及溶解。两组术中冰球覆盖率≥80%、<80%者分别为72.7%、27.3%和26.3%、73.7%,两组冰球覆盖率差别有显著性意义(P<0.05)。术后3个月,≤3cm和>3cm两组中,病灶缩小率≥50%的分别占81.8%和28.9%,两组病灶缩小率差别有极显著性意义(P<0.01)。结论超声和CT引导下氩氦刀冷冻治疗恶性肿瘤,定位准确,影像学改变明显、疗效确切、安全可靠,特别对小病灶效果显著。 | 赵勇洁 史秋生 | 2007 | 中国医学影像技术2007，23，2： | 13 |
| 6 | 冷冻消融治疗对胰腺癌患者细胞免疫功能影响的观察显示文摘目的:探讨胰腺癌患者冷冻消融治疗前后外周血T细胞亚群和NK细胞及TNF-α水平的变化及临床意义。方法:采用流式细胞术和ELISA法分别测定37例胰腺癌患者冷冻前后外周血T细胞亚群CD3、CD4、CD8和NK细胞及TNF-α的水平,并与健康对照组比较。结果:与对照组相比,患者术前的CD3、CD4、CD4/CD8及NK水平均明显降低,P<0.05,TNF-α水平明显升高,P<0.05;术后10dCD3和CD4及TNF-α水平均无明显变化,P>0.05,而CD4/CD8和NK水平均明显下降,P<0.05;术后30d所有指标的水平与对照组比较均差异无统计学意义,P>0.05。与术前比较,患者术后10d所有指标的水平差异均无统计学意义,P>0.05;而术后30dCD4和NK水平均明显升高,P<0.05,TNF-α水平显著下降,P<0.05。患者性别与所有指标的水平均无关(P>0.05),临床分期及肝转移与CD4、CD4/CD8、NK及TNF-α水平均相关,P<0.05。结论:冷冻消融治疗可增强胰腺癌患者的细胞免疫功能,检测外周血CD4、CD4/CD8和NK及TNF-α水平的变化,有利于胰腺癌患者的疗效和预后评估。 | 周刚 牛立志 邱大卫 何丽华 左建生 徐克成 王峰 黄丽雯 施娟娟 | 2011 | 中华肿瘤防治杂志2011，18，24： | 9 |
| 7 | 肝癌的冷冻治疗显示文摘冷冻疗法已成为治疗不能手术切除肝癌的重要手段.冷冻方法可选择手术中冷冻,切除或不切除肿瘤、腹腔镜下冷冻,或在超声、CT或MRI监测下,经皮冷冻.作为一局部治疗,冷冻具有超越其他治疗方法的若干优点:仅消融肝内肿瘤组织,而少伤及正常组织:由于大血管流动血流的温热作用,冷冻可安全地治疗临近大血管的肝肿瘤:冷冻比之手术更适宜治疗肝多发性肿瘤.冷冻联合肝动脉化学栓塞(TACE)、酒精注射或^(125)碘粒子植入,有相辅相成的作用.对于冷冻在肝癌治疗中应用.可归结如下:(1)小于5cm,尤其小于3cm的肝癌,数目不超过3个,可以手术中冷冻或经皮冷冻.(2)大于5cm的肝癌,先作TACE,再给予经皮冷冻.(3)大于5cm,边缘不整,预计冷冻不完全的肝癌,可予手术中或经皮冷冻,同时在冷冻区周边部注射酒精或植入^(125)碘粒子。 | 徐克成 牛立志 | 2008 | 世界华人消化杂志2008，16，3： | 9 |
| 8 | 化学栓塞-经皮冷消融序贯治疗不能切除的原发性肝癌显示文摘目的评价经皮肝冷消融联合经肝动脉化学栓塞对不能切除的原发性肝癌(PLC)的治疗价值。方法360例PLC患者接受治疗。肝内瘤块均大于5 cm。其中220例肿瘤为单个,其余为多个,但不超过5个。伴门静脉癌栓、肝衰竭(血清胆红素>34 mol/L,凝血酶原时间超过正常对照3 s)和明显腹水者除外。所有病例经过仔细评价,均失去手术切除机会。化学栓塞系采用经皮经肝动脉插管,视肿瘤部位,插管至左或右肝固有动脉或支配肝肿瘤的动脉分支。一般为碘化油和明胶海绵双重栓塞,同时给予化疗药, 常用表阿霉素40-60 mg、顺铂100 mg、丝裂霉素10-20 mg等。2周后作CT观察栓塞效果,如果肿瘤已被碘化油完全充填,则予冷消融治疗,否则再作化学栓塞,但不超过3次。冷消融采用氩氦冷冻系统(Cryocare,USA)进行,氩气作为冷却剂,靶组织内温度达-160℃,维持15-20 min后,给予氦气复温至20℃,共给予2次冷却-复温循环。必要时冷消融治疗后1个月再作化学栓塞1-2次。结果在中位随访期21个月(6-36个月)内,B超和/或CT随访显示,肿瘤完全反应(CR)30例(8.3%),部分反应(PR)228例(63.3%),无明显改变(NC)66例(18.3%),进展(PD)36例(10.0%)。血清甲胎蛋白(AFP)229例治疗前为320±285 g/L,治疗后有199例(86.9%)下降至126±85 g/L(P<0.05),其中142例(62.0%)降至正常范围。呈CR和PR的258例中,有69例(26.7%)在治疗后4-15个月内复发,但其中仅11例(15.9%)在原冷冻部位复发,其余均为异位生长。半年生存率为90.6%,1年为70.0%,2年为52.1%,3年为41.1%。死亡113例,死因为肝癌广泛转移45例,食管静脉曲张大出血24例,自发性腹膜炎23例,肝性脑病14例, 其他非肝癌相关性疾病7例。结论经皮肝动脉化学栓塞-经皮冷消融序贯治疗对不能手术切除的PLC 有良好效果,能使肿瘤退缩,延长患者生命。 | 徐克成 牛立志 何卫兵 郭子倩 左建生 胡以则 | 2004 | 现代消化及介入诊疗2004，9，3： | 8 |
| 9 | Advances in cryoablation for pancreatic cancer显示文摘Pancreatic carcinoma is a common cancer of the digestive system with a poor prognosis. It is characterized by insidious onset, rapid progression, a high degree of malignancy and early metastasis. Atpresent, radical surgery is considered the only curative option for treatment, however, the majority of patients with pancreatic cancer are diagnosed too late to undergo surgery. The sensitivity of pancreatic cancer to chemotherapy or radiotherapy is also poor. As a result, there is no standard treatment for patients with advanced pancreatic cancer. Cryoablation is generally considered to be an effective palliative treatment for pancreatic cancer. It has the advantages of minimal invasion and improved targeting, and is potentially safe with less pain to the patients. It is especially suitable in patients with unresectable pancreatic cancer. However, our initial findings suggest that cryotherapy combined with 125-iodine seed implantation, immunotherapy or various other treatments for advanced pancreatic cancer can improve survival in patients with unresectable or metastatic pancreatic cancer. Although these findings require further in-depth study, the initial results are encouraging. This paper reviews the safety and efficacy of cryoablation, including combined approaches, in the treatment of pancreatic cancer. | Xiao-Mei Luo Li-Zhi Niu Ji-Bing Chen Ke-Cheng Xu | 2016 | World Journal of Gastroenterology2016，22，2： | 7 |
| 10 | 胰腺癌患者氩氦刀冷冻消融治疗前后CA242、CA199、CA125、CEA、TSGF的变化及临床意义显示文摘目的:探讨胰腺癌患者氩氦刀冷冻消融治疗前后血清糖类抗原242(CA242)、糖类抗原199(CA199)、糖类抗原125(CA125)、癌胚抗原(CEA)及恶性肿瘤特异生长因子(TSGF)水平变化及临床意义。方法:测定30例胰腺癌患者氩氦刀冷冻消融治疗前后及15例正常对照的血清CA242、CA199、CA125、CEA及TSGF的水平,并分析其与临床病理参数的相关性。结果:胰腺癌患者冷冻前后所有标志物的血清水平及阳性率均明显高于对照组(P<0.05),冷冻后CA199、CA125及CEA血清水平均明显下降(P<0.05),冷冻后CA199,CEA及TSGF的阳性检出率均明显降低(P<0.05)。CEA血清水平与患者性别相关(P<0.05),CA242水平与肿瘤大小及临床分期均相关(P<0.05),CA199、CA125、CEA水平与患者年龄、肿瘤大小、临床分期、分化程度、淋巴结转移及肝转移均相关(P<0.05),而血清TSGF水平与所有的病理参数均无关(P>0.05)。结论:CA199、CA125、CEA血清水平可作为胰腺癌疗效评估的重要指标,CA242、CA199、CA125及CEA在胰腺癌的预后评估中发挥重要的作用。 | 周刚 牛立志 邱大卫 何丽华 石红霞 孔小峰 左建生 徐克成 | 2012 | 现代肿瘤医学2012，20，2： | 6 |
| 11 | Sorafenib Combined with Cryoablation to Treat Unresectable Hepatocellular Carcinoma显示文摘Objective:To evaluate the efficacy and tolerability of sorafenib combined with cryoablation in treating unresectable hepatocellular carcinoma (HCC).Methods:Patients with unresectable advanced HCC received cryoablation and sorafenib at a dose of 400 mg twice daily in 4-week cycles on the same day of the cryoablation.Tumor response,median overall survival and the median time to radiological progression were calculated and the toxicity was evaluated.Results:Seventy-eight patients with unresectable HCC were involved in this study.The median age was 52 years (range,22-81 years).The Eastern Cooperative Oncology Group (ECOG) performance status scores were 0 (39.7%),1 (55.1%),and 2 (5.1%).Nine (11.5%) patients were at Barcelona clinic liver cancer (BCLC) stage A,twenty-four (30.8%) patients were at stage B and 45 (57.7%) patients were at stage C.Five (6.4%) achieved partial responses,and 34 (43.6%) achieved stable disease.The median time to progression (TTP) for all enrolled patients was 6.6 months and the median overall survival (OS) was 12.2 months.Conclusion:Cryoablation combined with sorafenib demonstrates good efficacy and acceptable tolerability in treating unresectable advanced HCC patients. | Hong Ni Mao Yang Zhi Guo Ti Zhang | 2011 | Chinese Journal of Cancer Research2011，23，3： | 4 |
| 12 | 能谱CT评估非小细胞肺癌经皮氩氦刀冷冻消融术疗效显示文摘目的探索能谱CT成像对非小细胞肺癌氩氦刀冷冻消融术疗效评估的应用价值。方法收集接受CT引导下氩氦刀冷冻消融术的非小细胞肺癌患者23例(30次),于术前及术后(1~3个月)行GSI模式增强CT扫描,测量/计算手术前后病灶最大面积(S)、最大径(L)、强化区最大径(LE)、中心区和边缘区CT均值及碘含量均值变化率;分析WHO、RECIST、mRECIST标准及CTm-rec、Im-rec标准下,完全缓解(CR)、部分缓解(PR)、情况稳定(SD)、病情进展(PD),有效(CR+PR)、无效(SD+PD)患者的1年期生存率及整体生存期(OS)差异。结果 WHO、RECIST、mRECIST及CTm-rec标准下,1年期生存率随疗效变差而下降。RECIST标准下PR、SD、PD患者的OS差异有统计学意义(P=0.02);RECIST、mRECIST标准下SD与PD患者、CTm-rec标准下PR与PD患者、Im-rec标准下PR与SD患者的OS差异均有统计学意义(P=0.01、0.04、0.03、0.03)。CTm-rec及Im-rec标准下有效与无效患者的OS差异有统计学意义(P=0.04、0.03)。结论 Im-rec标准更敏感,CTm-rec标准可对术后病灶复发进行预测。能谱CT多参数联合应用有助于对非小细胞肺癌氩氦刀冷冻消融术后疗效的早期、全面评估。 | 庞冉 姜敏 刘明 王玲璞 刘冰 赵晶 | 2015 | 中国医学影像技术2015，31，8： | 4 |
| 13 | 肝癌的冷冻治疗显示文摘冷冻疗法己成为治疗不能手术切除肝癌的重要手段。冷冻方法可选择手术中冷冻,切除或不切除肿瘤、腹腔镜下冷冻,或在超声、CT下,经皮冷冻。作为一局部治疗,冷冻具有超越其他治疗方法的若干优点:仅消融肝内肿瘤组织,而少伤及正常组织;由于大血管流动血流的温热作用,冷冻可安全地治疗临近大血管的肝肿瘤;冷冻比手术更适宜治疗肝多发性肿瘤。冷冻联合肝动脉化疗栓塞(TACE)、酒精注射或125碘粒子植入,有相辅相成的作用。对于冷冻在肝癌治疗中应用,可归结如下:①<5cm,尤其<3cm的肝癌,数目不超过3个,可以手术中冷冻或经皮冷冻。②>5cm的肝癌,先作TACE,再给予经皮冷冻。③>5cm,边缘不整,预计冷冻不完全的肝癌,可予手术中或经皮冷冻,同时在冷冻区周边部注射酒精或植入125碘粒子。 | 徐克成 牛立志 | 2008 | 胃肠病学和肝病学杂志2008，17，5： | 4 |
| 14 | 胰腺癌患者冷冻消融治疗前后血清CD44v6和整合素β1的变化及在预后评估中的意义显示文摘目的探讨胰腺癌患者冷冻消融治疗前后血清中CD44v6及整合素β1表达水平的变化及与预后的相关性。方法 44例胰腺癌患者行冷冻消融治疗术,收集患者治疗前后及20名正常人(对照组)的血清标本,采用酶联免疫吸附试验(ELISA)测定CD44v6及整合素β1在血清中的表达水平。结果与对照组比较,患者术前和术后10 d CD44v6和整合素β1的表达水平均较高(P<0.05),而术后1个月的表达水平与对照组差异无统计学意义(P>0.05);术后患者的CD44v6和整合素β1的表达水平均逐渐下降,术后1个月二者的表达水平均明显低于术前(P<0.05)。CD44v6和整合素β1的表达水平与肿瘤大小、分化、临床分期、淋巴结转移及肝转移均明显相关(P<0.05),而与患者性别、年龄及肿瘤位置均无相关性(P>0.05)。CD44v6和整合素β1低表达患者术后的中位生存期分别为14.5个月和14.2个月,而高表达患者仅为9.5个月和9.8个月,二者间差异均有统计学意义(P<0.05)。结论 CD44v6和整合素β1的血清表达水平与胰腺癌的发生、发展、转移及预后等密切相关。 | 黄红莉 周刚 牛立志 石红霞 孔小峰 王峰 徐克成 | 2013 | 检验医学2013，28，12： | 4 |
| 15 | Tumour seeding after percutaneous cryoablation for hepatocellular carcinoma显示文摘AIM:To assess the rate and risk factors for tumour seeding in a large cohort of patients.METHODS:Over an 8-year period,1436 hepatocellular carcinoma(HCC) patients with 2423 tumour nodules underwent 3015 image-guided percutaneous cryoablation sessions [1215 guided by ultrasonography and 221 by spiral computed tomography(CT)].Follow-up CT or magnetic resonance imaging was performed every 3 mo.The detailed clinical data were recorded to analyse the risk factors for seeding.RESULTS:The median follow-up time was 18(range 1-90) mo.Seeding was detected in 11 patients(0.76%) at 1-24(median 6.0) mo after cryoablation.Seeding occurred along the needle tract in 10 patients and at a distant location in 1 patient.Seeded tumours usually showed similar imaging and histopathological features to the primary HCCs.Univariate analyses identified subcapsular tumour location and direct subcapsular needle insertion as risk factors for seeding.Multivariate analysis showed that only direct subcapsular needle insertion was an independent risk factor for seeding(P = 0.017;odds ratio 2.57;95%CI:1.47-3.65).Seeding after cryoablation occurred earlier in patients with poorly differentiated HCC than those with well or moderately differentiated HCC [1.33 ± 0.577 mo vs 11.12 ± 6.896 mo;P = 0.042;95%CI:(-19.115)-(-0.468)].CONCLUSION:The risk of seeding after cryoablation for HCC is small.Direct puncture of subcapsular tumours should be avoided to minimise seeding. | Chun-Ping Wang Hong Wang Jian-Hui Qu Yin-Ying Lu Wen-Lin Bai Zheng Dong Xu-Dong Gao Guang-Hua Rong Zhen Zeng Yong-Ping Yang | 2012 | World Journal of Gastroenterology2012，18，45： | 4 |
| 16 | 经皮冷冻治疗结直肠癌肝转移显示文摘背景:结直肠癌肝转移的手术切除率低,其他疗法效果亦欠佳。目的:探讨经皮冷冻治疗结直肠癌肝转移的疗效和安全性。方法:于超声或CT引导下,对326例不能手术切除的结直肠癌肝转移患者行经皮冷冻治疗,术后定期随访。结果:326例患者共接受526次经皮冷冻治疗。治疗后3个月,基线CEA水平升高者中77.6%降至正常范围。280例接受CT随访者中,冷冻病灶完全反应(CR)者14.6%,部分反应(PR)41.1%,稳定(SD)24.3%,进展(PD)20.0%。中位随访期为36个月(7~62个月),复发率为41.7%。全部病例中位存活期为29个月(3~62个月)。治疗后第1、2、3、4、5年存活率分别为78%、62%、41%、34%和23%。肿瘤直径≤3 cm、肝右叶肿瘤、冷冻前CEA≤10μg/L、冷冻后原先升高的CEA降至正常、冷冻治疗2~3次和冷冻后行经导管肝动脉化学栓塞(TACE)治疗者存活率较高。严重并发症发生率为5.2%。结论:经皮冷冻治疗结直肠癌肝转移安全、有效,可作为肿瘤不能手术切除者的替代治疗手段。 | 徐克成 牛立志 穆峰 周亮 胡以则 杨大明 左建生 | 2009 | 胃肠病学2009，14，9： | 3 |
| 17 | KAI1基因对MHCC97-H细胞裸鼠成瘤及转移的影响显示文摘目的:研究肿瘤转移抑制基因KAI1对MHCC97-H细胞裸鼠成瘤及转移的影响. 方法:将已转染KAIl正、反义核苷酸的高转移潜能肝癌细胞MHCC97-H接种裸鼠皮下,观察皮下肿瘤生长情况, 再将皮下肿瘤组织进行裸鼠原位肝接种,观察接种后肿瘤肺转移情况.其中,转染空载体及未转染的MHCC97-H亲本细胞作为实验对照组. 结果:正义组、反义组、空载体组及亲本细胞组裸鼠皮下均成瘤,肿瘤出现的时间、肿瘤块生长的速度无明显差异, 生长方式上反义组表现出明显的侵袭性.原位肝接种6 wk 后裸鼠肺部均出现癌巢,AFP染色可见癌巢中肿瘤细胞质有黄色颗粒沉着,证实为肝癌转移至肺形成的转移灶.与MHCC97-H亲本细胞组比较,反义组转移灶数目明显增加(P=0.00158),正义组转移灶数目明显减少(P=0.00465),差异均有显著性,而载体组传移灶数目无明显变化(P=0.15166). 结论:肿瘤转移抑制基因KAI1对MHCC97-H细胞裸鼠成瘤性及肿瘤生长无明显影响,但上调KAI1蛋白的表达水平能在一定程度上降低肿瘤的侵袭性、抑制转移的发生.这为肝癌的抗转移治疗研究提供了重要线索. | 彭志红 杨建民 唐波 司遂海 房殿春 罗元辉 | 2004 | 世界华人消化杂志2004，12，4： | 3 |
| 18 | 光动力联合经皮氩氦系统冷消融治疗非小细胞性阻塞性肺癌显示文摘目的:研究联合应用光动力疗法和经皮氩氦系统冷消融,对不能切除性非小细胞性阻塞性肺癌的治疗价值。方法:对因为肿瘤局部进展(按TNM分期为Ⅲb期),或因肺功能差(严重阻塞性肺疾病),被认为是不能切除性的非小细胞性阻塞性肺癌患者41例,先予静脉注射光敏剂Photofrin2mg/kg或血卟啉5mg/kg,48和72小时在支气管镜下输入630nm红色激光照射;再在B超或CT引导下通过氩氦系统进行经皮冷消融。按症状、肿瘤大小和生存期判断疗效。结果:治疗后37例(90.2%)主观症状改善,症状积分明显降低,呼吸困难改善最为明显;支气管镜发现全部患者支气管内肿瘤均得到不同程度消融,其中完全消失17例(41.5%);CT复查发现肺内肿瘤CR14例(34.1%),PR17例(41.5%);X线片上原有肺不张27例中8例(29.6%)肺不张完全消失,19例(70.4%)肺不张减轻;半年和1年生存率分别达43.9%和70.7%。无论光动力抑或经皮氩氦系统冷消融,均未发生严重不良反应。结论:联合应用光动力疗法和氩氦系统经皮冷消融,能分别消除支气管内、外的病变,两者相辅相成,因而可提高不能切除性非小细胞性阻塞性肺癌的治疗效果。 | 郭子倩 牛立志 何卫兵 左建生 徐克成 | 2006 | 中国交通医学杂志2006，20，1： | 2 |
| 19 | 氩氦刀消融结合中药治疗中晚期肝癌72例显示文摘氩氦刀采用超低温快速冷冻的方法摧毁肿瘤组织,具有操作简单、损伤小、安全、高效等优点。我国1999年引进该技术,目前已广泛应用于肺癌、肝癌、肾癌、前列腺癌等实体肿瘤的治疗[1-3]。氩氦刀治疗实体肿瘤有多种方法, | 朱旭东 魏璐婉 隆新霞 吴琦 巩瑞红 张茂臣 王保明 丁兆习 刘执玉 | 2011 | 中国现代普通外科进展2011，14，9： | 2 |
| 20 | 冷冻联合^125Ⅰ粒子植入治疗局部进展性胰腺癌显示文摘目的探讨冷冻联合^125Ⅰ粒子植入治疗局部进展性胰腺癌的价值。方法49例无法手术切除的进展性胰腺癌患者,予以术中或经皮冷冻治疗;同时或术后植入^125Ⅰ粒子。部分患者术后接受腹腔动脉灌注化学治疗。对治疗效果、不良反应及患者存活期进行分析。结果分别有13、36例患者行术中和经皮冷冻治疗。35例患者同时植入^125Ⅰ粒子,另14例则在冷冻术后实施。20例患者接受局部化学治疗。治疗3个月后,CT检查多数患者肿瘤不同程度坏死,其中完全缓解(CR)占20.4%、部分缓解(PR)38.8%、病情稳定(SD)30.6%、病情进展(PD)10.2%。主要不良反应包括上腹痛、血清淀粉酶升高;6例并发急性胰腺炎,其中1例属重症。经相关处理,均得到有效控制。无一例因治疗而死亡。随访中位时间18个月(5~40个月),中位存活期为16.21个月,有26例(53.1%)存活期≥12个月,8例存活期≥24个月。6、12、24和36个月时的平均存活率分别为94.1%、53.1%、22.8%和9.5%。最长的1例存活〉46个月,无肿瘤复发征象。结论冷冻治疗的创伤性小,且不良反应发生率低,可作为局部进展性胰腺癌患者的首选疗法。联合应用^125Ⅰ粒子植入能获得更佳效果。 | 徐克成 牛立志 胡以则 穆峰 周亮 李鹰飞 杨大明 左建生 | 2009 | 中华消化杂志2009，29，4： | 2 |
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