肝右叶前、后段原发性肝癌动脉化疗栓塞术后近期疗效比较  

Short-term effects of TACE for primary hepatocellular carcinoma of the right hepatic lobe: a comparison between the lesions in anterior segments and the lesions in posterior segments

作　　者：沈海洋[1] 杨光[1] 刘瑞宝[1] 何东风[1] 杨奕[1] 孙厚宾[1] 王惠文[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院介入科,150081

出　　处：《介入放射学杂志》2010年第5期382-385,共4页Journal of Interventional Radiology

摘　　要：目的分析位于肝右叶前、后段原发性肝癌(HCC)患者在TACE治疗后病灶近期疗效的差异及意义。方法回顾性分析我院2008年3月-2009年1月首次行肝动脉化疗栓塞术(TACE)治疗283例HCC患者,将其中按影像学检查符合筛选标准58例(83个病灶)分两组。A组:共23例,病灶位于肝右叶前段(Ⅴ、Ⅷ段);B组:共35例,病灶位于肝右后段(Ⅵ、Ⅶ段)。分析经TACE治疗前1周内及治疗后1、3个月复查的CT、MRI资料,按照RECIST标准比较两组病灶近期疗效的差异。结果治疗1个月后A、B两组的CR、PR、SD、PD分别为0、4.3%、87.0%、8.7%和0、22.9%、68.6%、8.6%,有效率OR(CR+PR)比较差异无统计学意义(P=0.073);3个月后两组的CR、PR、SD、PD分别为0、8.7%、73.9%、17.4%和0、34.3%、62.9%、2.9%,OR比较差异有统计学意义(P=0.031);两组病灶大小随时间变化,后段组比前段组缩小明显(F=7.873,P<0.05)。结论肝右叶后段HCC经TACE治疗后短期疗效优于前段,对于不同位置病灶的综合治疗有重要指导价值。Objective To compare the short-term curative effects of transcatheter arterial chemoem-bolization （TACE） between the lesions located in anterior segments and the lesions located in posterior segments of the right hepatic lobe in primary hepatocellular carcinoma （HCC）, and to discuss its clinical significance. Methods From March 2008 to January 2009, initial TACE was performed in 283 patients of HCC at our institute. The clinical data were retrospectively reviewed and analyzed. Of 283 cases, 58 （83 lesions） met the inclusion criterion. According to CT or MRI findings, 58 patients were divided into two groups. Group A consisted of 23 cases whose lesions were located at anterior segments （V, VIII） of the right lobe, while group B included 35 cases whose lesions were located at posterior segments （VI, VII） of the right lobe. CT and MRI manifestations one week before TACE and one, three months after TACE were carefully observed. Based on RECIST criteria, the short-term effects of TACE between two groups were compared and statistically analyzed. Results One month after TACE the CR, PR, SD, PD of group A and group B were 0%, 4.3%, 87.0%, 8.7% vs 0%, 22.9%, 68.6%, 8.6%, respectively. The difference in OR （CR ＋ PR） between two groups was of no statistical significance （P = 0.073）. Three months after TACE the CR, PR, SD, PD of group A and group B were 0%, 8.7%, 73.9%, 17.4% vs 0%, 34.3%, 62.9%, 2.9%, respectively. The difference in OR （CR ＋ PR） between two groups was statistically significant （P = 0.031）. The lesions in both groups tended to decrease in size with time, and the reduction degree of the lesion volume in group B was more obvious than that in groups A （F = 7.873, P〈 0.05）. Conclusion The short-term curative effect of TACE for lesions in the poster segments of right hepatic lobe is better than that in the anterior segments of right hepatic lobe. This finding is very helpful in guiding comprehensive treatment of the lesions located in different anatomic regions.

关 键 词：肝细胞癌 经导管动脉化疗栓塞 肝段 近期疗效 

分 类 号：R735.7[医药卫生—肿瘤]