肝切除术中经大网膜静脉注射丝裂霉素预防小肝癌术后肿瘤复发  

Preventing tumor recurrence following liver resection of small HCC by injecting Mitomycin-C through omentum majus vein

作　　者：黄杨卿[1] 沈伟峰[1] 杨甲梅[1] 阚彤[1] 徐峰[1] 谢峰[1] 

机构地区：[1]第二军医大学东方肝胆外科医院特需科,上海200438

出　　处：《中国现代医学杂志》2009年第14期2173-2175,共3页China Journal of Modern Medicine

摘　　要：目的分析肝细胞癌肝切除术中,经大网膜静脉注射丝裂霉素(Mitomycin-C,MMC)预防术后肿瘤复发的疗效。方法回顾分析2002年1月～2004年12月,127例肝细胞癌行肝切除患者的临床资料。患者肿瘤全部为单发,且最大直径≤5cm,无肉眼血管侵犯。其中术中经大网膜静脉注射MMC的用药组共计67例,未行任何化疗药物注射的对照组共计60例,随访术后复发情况。结果用药组与对照组无瘤生存时间差异有显著性,中位无瘤生存时间分别为48个月和21个月(P=0.0043),术后复发率部分差异有显著性(术后24个月:32.84%和56.67%,P=0.0069)。COX回归分析提示MMC是影响复发的危险因素,相对危险度是0.528(P=0.006)。结论小肝癌行肝切除术,术中经大网膜静脉注射丝裂霉素,对于预防术后复发有积极意义。但对于较大之肿瘤及合并血管侵犯及多发肿瘤,该方法是否具有相似的效果将是进一步研究关注的问题之一。[Objective] To estimate the value of the methed of MMC injected through greater omentum majus vein after the resection of tumor during the operation to prevent the recurrence of small HCC. [Methods] A retrospective analysis of 127 patients was done. All of them received liver resection of HCC from 2002 Jan. to 2004 Dec. Group A include 67 patients who was injected MMC through greater omentum majus vein after the liver tumor was resected 60 patients who was not injected MMC was recruited into group B. All patients had a single tumor ≤5 cm without visible vessel invasion. [Results] There was significant difference between two group of the period of disease-free survival （DFS）, and median period of DFS of group A vs. group B was 48 months vs 21 months after the first operation （P =0.0043）. Postoperative tumor recurrence rate was significant difference at the 24th month. COX regression showed that the DFS time was significantly affected by MMC, and hazard ratio was 0.528 （P =0.006）. [Conclusion] Injection of MMC through greater majus omentum vein after the liver tumor was resected is a valuable method to prevent the recurrence of small HCC. We need more trial to prove its therapeutic effect in bigger tumor, mutiple tumor and tumor with visible vessel invasion.

关 键 词：肝细胞癌 肝切除 复发 术中化疗 丝裂霉素 

分 类 号：R735.7[医药卫生—肿瘤]