摘要
目的探讨中晚期原发性肝癌（HCC）经门静脉、肝动脉双重介入治疗使肿瘤缩小后切除的疗效及意义。方法30例中晚期肝癌患者（肿瘤直径8．0～20．0cm，平均10．2cm）在超声引导下行门静脉化疗及经皮穿刺肝动脉化疗栓塞（TACE），观察肝功能，AFP，各肝叶体积及不良反应，并择期手术切除肿瘤。结果手术前肿瘤平均直径缩小至4．9cm，末次TACE距手术时间为1～3个月，平均1．6个月。25例AFP阳性中9例转正常。30例患者中，行肝段、联合肝段或肝部分切除25例，左半肝切除4例，左外叶切除1例。切除肿瘤中各有60％～100％坏死，其中12例100％坏死。1、3、5年生年率分别为80％、68％、59％。结论术前经门静脉、肝动脉双重介入治疗可为一期不能切除的中晚期肝癌患者提供二期手术机会，提高手术的安全性，对预防转移、延迟复发、改善预后有肯定意义。
Objective To study the the therapeutic result of hepatic resection for those middle-advanced hepatocelluar carcinoma（HCC） shrunked after chemotherapy via portal and transcatheter hepatic arterial chemoembolization（TACE） interventional treatment. Methods Among the 30 patients, the maximum diameter of the tumor was 8.0 to 20.0cm prior to the first chemotherapy via portal and TACE, mean 10.2cm. The patients underwent chemotherapy via portal by US guidance and TACE. The patients＇ liver function, AFP, tumors diameter, enlarge of normal liver lobe： and the side effect were observed. 30 patients were done hepatic resection after chemotherapy via portal and TACE interventional treatment. Results The tumor diameters were reduced to 4.9era prior to operations. The duration between the last TACE treatment and sequential resection varied from 1 to 3 months,mean 1.6 months. Of the 30 patients,25 patients＇ serum alPha-fetoprotein（AFP） levels were elevated. AFP levels returned to normal after chemotherapy via portal and TACE interventional treatment in 9 patients. Of the patients, liver segmentectomy, combined liver segmentectomy or partial liver resection was performed in 25 patients,left trilobectomy in 1 patient and left hemihepatectomyin 4. Tumor necrosis ranged from 60 % to 100 % pathologically and complete tumor necrosis occurred in 12 patients. The 1.. 3- and 5-year survival rate were 80 %, 68 %, 59 % ,respectively. Conclusion Chemotherapy via portal and TACE interventional treatment can provide chance of tumor resection for those patients with middle-advanced HCC and be of certain value in preventing metastasis, improving prognosis and prolonging the period of survival.
出处
《中国基层医药》
CAS
2007年第2期264-266,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
化学栓塞
治疗性
肝肿瘤
肝切除术
Chemoembolization, therapeutic
Hepatocelluar neoplasma
Hepatectomy
