不同介入方法对门脉主干癌栓疗效的初探  

THE EFFECT OF DIFFERENT INTERVENTIONAL THERAPIES FOR HEPATOCELLULAR CARCINOMA WITH TUMOR THROMBUS OF MAIN PORTAL VEIN

作　　者：刘崎[1] 贾雨辰[1] 田建明[1] 王振堂[1] 叶华[1] 杨继金[1] 孙飞[1] 林琳[1] 贺佳[2] 

机构地区：[1]第二军医大学附属长海医院放射科,上海200433 [2]第二军医大学统计学教研室,上海200433

出　　处：《肝胆外科杂志》1999年第1期17-20,共4页Journal of Hepatobiliary Surgery

摘　　要：目的通过分析经肝动脉不同介入方法对肝癌并门脉主干癌栓患者的治疗作用，评价不同方法的疗效。方法对182例原发性肝癌合并门脉主干癌栓患者行二次以上介入治疗，26例单纯肝动脉内灌注化疗药物（A组），42例化疗加碘油（B组），114例化疗加碘油及明胶海绵颗粒栓塞（C组）。结果①肿瘤缩小率＞50％者，A组0，B组23．8％，C组32．5％，统计学显示相差非常显著（P＜0．001）。②治疗后门脉瘤栓消失率A组为7．7％，不变率为84．6％；B组分别为21．4％、54．8％；C组为37．7％和40．4％。统计显示有显著差异（P＜0．001）。③1、3年生存率分别为A组11．5％，0；B组21．4％，2．4％；C组33．3％，3．6％，C组中有一患者已存活10年。A、B组和B、C组间均差异显著（P＜0．05），A、C组差异非常显著（P＜0．01）。结论对于肝癌并门脉主干癌栓的治疗，TAI疗效不佳，只要选择病人得当，TACE治疗可取得良好的疗效。To evaluate the therapeutic effect of various interventional therapy for hepatocellular carcinoma with tumor thrombus of main portal vein. Methods One hundred and eighty-two patients with hepatocellular carcinoma and main parotal vein thrombus were given more than 2 times of interventional treatment via hepatic artery. Among them 26 cases were givenchemotherapy alone (group A), 42 chemoembolization with lipiodol (group B), and 114 chemoembolization with lipiodol andgelfoam (group C). Results ① The tumor size reduced by> 50% was 0 of group A,23. 8% of group B and 32. 5% of group C.①The disappearance rates of the tumor thrombus of main portal vein were 7. 7%, 21. 4% and 37. 72% for group A,B and C respectively. ③The 1, 3-year survival rates were 11. 5 % and 0 for group A, ZI. 4% and 2. 4% for group B,and 33. 3% and 3. 6%for group C respectively. There was obvious difference among the three groups(p<0. of). Conclusion TACE can achieve a goodtherapeutic effect,if the proper patients are chosen. While TAI have no effect on hepatocellular carcinoma with tumor thrombus ofmain portal vein.

关 键 词：肝癌 介入疗法 门静脉癌栓 

分 类 号：R735.705[医药卫生—肿瘤] R730.59[医药卫生—临床医学]