目的对高强度聚焦超声（high intensity focused ultrasound, HIFU）治疗乳腺纤维腺瘤的疗效进行评价。方法回顾性分析我科收治的24例乳腺纤维腺瘤患者的治疗资料。结果HIFU治疗术后恢复快，平均于术后1.5 d出院，无并发症发生； 术后随访3~12个月，有2例患者乳房包块消失，5例包块不同程度缩小，未消失包块针吸活检显示为坏死组织。结论HIFU治疗乳腺纤维腺瘤较为安全、有效，既能保持乳房外形美观，又不损害乳房功能，具有良好的应用前景。
Objective To study the mechanism of high intensity focused ultrasound (HIFU) and discuss its clinical significance in the treatment of mid-late stage liver cancer. Methods The patients with mid-late stage liver cancer were treated with HIFU. The changes of photography, pathology and immunology after operation were evaluated. Results It was shown that the results of the photographic, pathologic and immunologic examinations changed during the treatment of the patients with HIFU. Conclusion HIFU is effective and safe for the treatment of mid-late stage liver cancer.
ObjectiveTo evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RTPCR.Results①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis (P＜0.05). ②In 8 cases with preoperative AFP mRNA negative, only 2 cases became AFP mRNA positive immediately after therapy, and one of the 2 cases became negative again after 72 hours. One week after HIFU therapy, the AFP mRNA positive rate (31.6%) was much lower than the preoperative positive rate (57.9%), but there was no statistical significance (Pgt;0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm (P＜0.05). ConclusionHIFU may reduce the spreading of hepatocellular carcinoma cells in blood. It is effective for patients with tumor size less than 8 cm.
bjectiveTo evaluate the efficacy and limits of high intensity focused ultrasound (HIFU) in tumor treatment. MethodsThe references about the application of HIFU in tumor treatment in recent years were reviewed.ResultsHIFU caused localized hyperthermia at predictable depth in a few seconds to make the tumor tissue coagulative necrosis without injuring surrounding tissue. HIFU treatment had the advantages of low morbidity, noninvasiveness, avoidance of systemic side effects, and repeatitiveness. However, the utilization of HIFU sometimes could be limited by some factors such as imaging technique, organ movement, incomplete tissue destruction, etc.ConclusionHIFU is a promising noninvasive therapy for tumor treatment, though there are lots of problems to be further studied.
Objective To assess the survival of patients receiving high intensity focused ultrasound (HIFU) and investigate the prognostic factors for primary hepatocellular carcinoma (PHCC) victims with HIFU application. Methods One hundred and eighty-seven patients with PHCC undergoing HIFU treatment in our department were enrolled into this study from June 2004 to June 2007. Among them, 101 patients were males and 86 were females (mean age: 47.7 years old, range: 19-79 years old). The average tumor size was 5.7 cm (range: 0.5-18.0 cm). Of these 187 patients, numbers according to Child-Pugh grade of A, B and C were 104, 52 and 31, respectively. According to TNM system, 45, 111 and 31 patients were in stage Ⅱb, Ⅲa and Ⅲb respectively. Kaplan-Meier model and log-rank test were used in univariate analysis and Cox regression model was used in multivariate analysis to identify prognostic factors for survival. Results Survival period was (17.3±2.5) months after HIFU treatment of PHCC. The overall survival rate of 3-month, 6-month, 1-year and 2-year were 79.1%, 60.1%, 35.7%, and 29.3%， respectively. It was significant that tumor number (P=0.02), size (P=0.04)， AFP (P=0.04)， Child-Pugh grade (P=0.00)， TNM stage (P=0.01)， tumor metastasis (P=0.03) before HIFU， and tumor recurrence after HIFU (P=0.02) and standard treatment (P=0.02) were prognostic factors by single factor analysis. The following factors were identified as independent prognostic factors for overall survival by multivariate model: standard treatment protocol (P=0.000), and TNM stage (P=0.004) and Child-Pugh grade (P=0.009) before HIFU. Conclusion It is used for improving overall survival rate to found PHCC early, protect liver function, examine comprehensively before HIFU treatment, focus on standard treatment and auxiliary treatment.
目的 探讨高强度聚焦超声(HIFU)治疗乳房纤维腺瘤的临床效果。 方法 分析、总结我院2002年10月至2005年9月50例经HIFU 治疗的乳房纤维腺瘤患者的临床资料。结果 患者住院时间短，平均2.9 d； 无并发症发生； HIFU 治疗后纤维腺瘤退变坏死，乳房包块逐渐缩小、消失。结论 HIFU治疗乳腺纤维腺瘤安全、有效、简便，且不损害乳房形态和功能，临床应用前景良好。
【Abstract】ObjectiveTo investigate the effect of high intensity focused ultrasound (HIFU) on the immunity of patients with advanced primary liver cancer (PLC). MethodsForty cases of PLC admitted to our institution from Mar. 2003 to Dec. 2003 were included in this study. Patients were divided into 2 groups and received either HIFU or radiofrequency ablation (RFA) treatment randomly. CD3, CD4, CD8, CD4/CD8, NK, IL-2, TNF were chosen to assess the immune status before and after treatment. The results were compared statistically. ResultsThe survival rate after HIFU was 80.0%, 61.1%, 42.9%, 33.3% at 3 months, 6 months, 9 months and 1 year respectively, which was similar to that after RFA treatment. The changes of immunity parameters of CD3, CD4, CD8, CD4/CD8, NK, IL-2 and TNF were not significant after HIFU treatment. In addition, the differences of those parameters between HIFU group and RFA group were insignificant. ConclusionThere are no detrimental effects on immunity in the early period after HIFU treatment.
ObjectiveTo probe into the clinical efficacy of high-intensity focused ultrasound (HIFU) alone for uterine fibroids. MethodBetween February 2012 and February 2014, 145 patients with 174 cases of uterine fibroids were treated with HIFU. Before and one day, 6 months, 12 months after treatment, MRI was performed during the follow-up. We analyzed fibroids narrowing rate, adverse reactions, and clinical symptoms improvement after treatment. ResultsSuccessful completion of HIFU ablation was done for all the fibroids. Enhanced MRI examination before and one day after treatment, and MRI plain scanning 6 and 12 months after treatment showed that fibroid volume before treatment was 4.61-419.70 cm3 (median of 56.82 cm3), fibroid volume after treatment was 3.02-578.21 cm3 (median of 56.74 cm3), ablation volume was 2.42-578.21 cm3 (median of 47.84 cm3), and volumetric ablation rate was 24%-100%; there was no statistically significant difference in fibroid volume before and after treatment (P>0.05); fibroid volume 6 months after treatment was 0-264.50 cm3 (median of 22.49 cm3) and was 0-346.02 cm3 (median of 14.81 cm3) 12 months after treatment with a reduction rate of 60.4% and 73.9% on average respectively, and the volume was significantly different between those two time points and before treatment (P<0.05), and between 6 months and 12 months after treatment (P<0.05). The medians of uterine fibroid symptoms (UFS) and quality of life (QOL) scores before ablation were respectively 21.88 and 71.55 points. UFS reduced by 57.1% and 71.4% respectively 6 and 12 months after ablation, and QOL increased by 15.7% and 26.5% at those two time points. Both UFS and QOL 6 and 12 months after treatment were significantly different from that before treatment (P<0.05), and the UFS and QOL difference between 6 months and 12 months after treatment was also significant (P<0.05). As time went on, UFS gradually reduced, while QOL gradually increased. Complication rate was 2.8% with two cases of skin shallow degree-Ⅱ thermal damage, one of lower limb radiation pain, one of urinary retention, and there were 6 cases of recurrence during the follow-up. ConclusionsHIFU treatment for uterine fibroids is safe and effective, and is an alternative choice for conventional treatment when it is unable to retain the womb or when the patient refuses surgical treatment.