Clinical study of percutaneous quantified ethanol injection in treatment for recurrent hepatocellular carcinoma under liver capsular guided by ultrasound

Objective To evaluate the clinical application of percutaneous quantified ethanol injection(PQEI) in the treatment for recurrent hepatocellular carcinoma(HCC) under liver capsular.Methods The tumors under liver capsular in 136 cases of clinicopathologically proved HCC were injected with ethanol guided by ultrasound once every 2-3 days.The quantity of ethanol was calculated according to the regressive equations which were Y=(2.885)X when the mass was ≤5 cm in diameter and Y=(1.805)X when the mass was 5 cm in diameter(X is the maximal diameter of the mass with the unit cm,Y is the ethanol quantity with the unit ml).The ethanol was injected for 4-10 times per period for tumors ≤5 cm in diameter and 10-20 times per period for tumors 5 cm in diameter.The follow-up period lasted 12-60 months.The therapeutic efficacy was assessed by clinical symptom,the result of ultrasound,CT,MRI,color three-dimension ultrasound and biopsy.The survival rates of 1,2,3,4,5 years were calculated.Results(The masses) of HCC shrank from(3.4) cm to(2.6) cm in average diameter after 2-8 weeks.After the treatment fine-needle biopsy proved degenerated cancer cells in(7.9)%(10/136) cases of nodules (4.5) cm in diameter and no cancer cells in the other(92.1)%(126/136) cases.After therapy AFP reduced in 112 cases with high AFP before therapy and(88.2)%(99/112) cases turned negative.The survival rates of 1,2,3,4,5 years were(93.4)%,(83.1)%,(72.8)%,(63.1)% and(51.9)%,respectively.The median survival time was(47.7) months.There were no serious complications.Conclusions The treatment efficacy of PQEI for recurrent HCC under liver capsular is of high clinical application value and deserves further research.