外科综合治疗对肝细胞癌合并门静脉癌栓的疗效观察  

Therapeutic efficacy of comprehensive surgical management for hepatocellular carcinoma accompanied by tumor thrombi in portal vein

作　　者：程树群[1] 吴孟超[1] 陈汉[1] 杨家和[1] 丛文铭[1] 王培军[1] 赵玉祥[1] 

机构地区：[1]第二军医大学东方肝胆外科医院,上海市200438

出　　处：《中华肝胆外科杂志》2004年第10期662-664,共3页Chinese Journal of Hepatobiliary Surgery

基　　金：上海市科学技术委员会 (0 1QB14 0 0 3 );上海市医苑新星计划 (2 0 0 2 )

摘　　要：目的　探讨外科综合治疗对肝细胞癌合并门静脉癌栓的疗效。方法　 2 0 0 0年 1月至2 0 0 3年 1月 ,36例肝癌伴门静脉癌栓病人根据外科治疗方法不同而分为 3组 :切除 +TACE +胸腺肽(A组 ,n =9) ,切除 +TACE(B组 ,n =2 0 )和切除组 (C组 ,n =7)。回顾分析这 3组病人的中位生存期和不同分型癌栓 (Ⅰ～Ⅳ型 )治疗后的疗效。结果　A、B、C 3组病人的中位生存期分别为 10 0个月、7 0个月和 8 0个月 ,各组差异无显著性意义 (P =0 12 4 0 )。就癌栓分型而言 ,外科综合治疗有助于提高I型癌栓病人的生存期。结论　外科综合治疗有助于提高肝癌合并门静脉癌栓病人的生存期 ,尤其是癌栓位于门静脉二级以上的病人。Objective To investigate the therapeutic effects of comprehensive treatment using surgical resection plus TACE and thymosin α 1 on hepatocellular carcinoma (HCC) accompanied by tumor thrombi in the portal vein. Methods From January 2000 to January 2003, 36 patients with HCC accompanied by portal vein tumor thrombi were treated in our hospital. Of the 36 patients, 9 (group A) received resection plus TACE and thymosin α 1, 20 (group B) resection plus TACE and 7 (group C) resection alone. The median survival period was compared among the 3 groups. Results The median survival period was 10 0, 7 0 and 8 0 months in group A, group B and group C, respectively. The outcome was better in patients with tumor thrombi of type Ⅰ than in those with that of type Ⅱ or Ⅲ. Conclusions The comprehensive treatment using resection plus TACE and thymosin α 1 may prolong the survival time of patients with HCC accompanied by portal vein tumor thrombi, especially those with tumor thrombi locating in segmental branch of portal vein or above.

关 键 词：病人 外科综合治疗 门静脉癌栓 切除 肝细胞癌 中位生存期 TACE 显著性 

分 类 号：R735.7[医药卫生—肿瘤] R657.51[医药卫生—临床医学]