术后经导管动脉化疗栓塞对不同病理特征肝癌的抗复发作用  

Role of post-operative transcatheter arterial chemoembolization in hepatocellular carcinoma with different pathological characteristics

作　　者：奚韬[1] 闫振林[1] 王葵[1] 李俊[1] 夏勇[1] 沈锋[1] 吴孟超[1] 

机构地区：[1]第二军医大学东方肝胆外科医院综合治疗一科,上海200438

出　　处：《中华外科杂志》2007年第9期587-590,共4页Chinese Journal of Surgery

摘　　要：目的了解预防性经导管动脉化疗栓塞(TACE)对不同肿瘤生物学特性肝癌的抗复发作用。方法1996年10月至2001年9月,对收治的823例肝癌患者进行了肝癌切除术,其中126例(15.3%)术后行预防性TACE。以肿瘤生物学特性的不同将患者进行分组,评价预防性 TACE 对具有不同生物学特性的肝癌患者的抗复发作用。结果对于肿瘤直径≤3 cm 的患者,术后实施 TACE 并未能降低其复发率,反而可能导致肝功能损害,给之后治疗手段的选择带来限制;而对肿瘤直径为>3～10 cm、甲胎蛋白(AFP)阳性且伴有血管侵犯和肿瘤直径≥10 cm、伴有 AFP 阳性、存在子灶和血管侵犯、手术切缘<1 cm 的患者,则建议术后在系统情况良好、肝功能恢复后尽早行 TACE。结论术后 TACE 对具有术后复发高风险的患者具有降低复发率延长生存时间的作用。Objective To evaluate the efficacy of transcatheter arterial chemoembolization （TACE） on postoperative recurrence of hepatocellular carcinoma. Methods A total of consecutive 823 patients with hepatocellular carcinoma from October 1996 to September 2001 were included in this study. All patients underwent curative liver resection and 126 patients （ 15.3% ） received TACE post operation. The effects of postoperative TACE on the recurrence of hepatocellular carcinoma with different pathological characteristics such as tumor size, tumor capsule, number of nodules, vascular invasion and surgical margin was analyzed. Results Postoperative TACE had not decreased the recurrence rate in patients with a tumor diameter less than 3 cm. Postoperative TACE increased the disease-free survival for patients with tumor diameter of 3 - 10 cm, positive in alpha fetoprotein （ AFP）, presented vascular invation or patients with tumor diameter larger than 10 cm, positive in AFP, muti-nodular, presented vascular invation, resection margin less than 1 cm. Conclusions Postoperative TACE can decrease recurrence rate and prolong the survival of hepatocellular carcinoma patients with high risk factors for recurrence.

关 键 词：肝肿瘤 复发 生存 经导管动脉化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]