中文摘要：

目的探讨经皮超声引导下射频消融（RFA）治疗结直肠癌肝转移（CRLM）的疗效及预后因素。方法回顾性分析192例接受经皮超声引导下RFA治疗的CRLM患者临床及影像资料,其中原发肿瘤为结肠癌者105例,直肠癌者87例。结果 192例患者共接受RFA治疗302例次,肝转移灶共437个。首次RFA治疗后1个月肿瘤总体灭活率93.59%（409/437）。肿瘤局部复发率为11.21%（49/437）,平均复发时间为RFA治疗后（9.34±7.25）个月（2~34个月）。治疗后肝内新生转移灶发生率48.96%（94/192）。患者1、3、5年总体生存率分别为87.0%、40.8%、16.5%。单因素分析结果显示,肿瘤数目（P=0.003）、最大径（P=0.001）、肝内分布（P=0.001）及治疗后1个月肿瘤灭活情况（P=0.007）是影响患者生存率的潜在危险因素。多因素分析结果显示,肿瘤数目（P=0.001）及最大径（P=0.001）为患者生存率的独立影响因素。RFA治疗后较严重并发症发生率为3.31%（10/302）,未发生治疗相关性死亡。结论 RFA是一种安全、有效的CRLM治疗方法,肿瘤最大径≤3cm及单发肝转移灶患者预后较好。

英文摘要：

Objective To explore the effect and prognostic factors of percutaneous ultrasound-guided radiofrequency abla- tion （RFA） for colorectal liver metastases （CRLM）. Methods The clinical and imaging data of 192 patients with CRLM who underwent percutenous ultrasound-guided RFA were retrospectively analyzed. There were 105 cases with the primary tumor of colon carcinoma and 87 cases with the primary tumor of rectum carcinoma. Results Percutenous ultrasound- guided RFA was performed on totally 192 patients with 437 lesions for 302 sessions. The overall ablation success rate was 93.59% （409/437） 1 month after RFA. The local recurrent rate was 11.21% （49/437） and the mean interval between RFA and recurrence was （9.34±7.25） monthes （ranged 2-34 monthes）. And the new metastasis rate was 48. 96% （94/ 192）. The overall survival rates of 1, 3 and 5year was 87.0%, 40.8% and 16.5%, respectively. Tumor number （P= 0. 003）, diameter （P=0. 001）, distribution （P=0. 001） and success ablation of 1 month after RFA （P=0. 007） were potential risk factors for survival rates by univariate analyses. Tumor number （P=0. 001） and diameter （P=0. 001） were in- dependent prognostic factors by Cox multivariate model. The severe complication rate was 3.31% （10/302）, and no treat- ment-related death occurred. Conclusion RFA is a safe and effective therapeutic option for colorectal liver metastases, es- pecially for those with diameter ≤3 cm and solitary tumor.