肝细胞癌合并门脉瘤栓的TACE疗效评价  

Efficacy of transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma with tumor thrombus in the portal vein

作　　者：廖伟[1] 郭启勇[1] 刘兆玉[1] 卢再鸣[1] 张军[1] 

机构地区：[1]中国医科大学附属第二医院放射科,110003

出　　处：《中国临床医学影像杂志》1999年第2期113-116,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：评价TACE治疗肝癌合并门脉瘤栓的疗效。材料与方法：经TACE治疗的合并门脉瘤栓的HCC患者59冽，主干瘤检29例，一级分支瘤栓30例。根据栓塞方法分为：GS组（n＝21）、LP组（n＝10）、混合组（n＝28）。分别以瘤栓变化及生存时间作为近、远期疗效评价指标。结果：3组近期疗效有效率分别为38．1％，0％，50％，GS组及混合组疗效优于LP组（p＜0．05）；3种TACE方法对门脉瘤栓缩小的有效率分别为GsTACE50％、LpTA5．7％，LpGsTACE24．1％，GsTACE疗效优于后两者（p＜0．05）；混合组远期疗效优于另两组（p＜0．05），其3，612个月生存率分别为89．2％，52．0％，18．6％；近期疗效有效组生存率优于无效组（p＜0．01），有效组3、6、12个月生存率分别为100％，59．1％，19．8％。结论：对于合并门脉瘤栓的HCC患者，应用Gs的TACE治疗效果优于无Gs的TACE治疗。GsTACE应作为门脉瘤栓治疗的首选方法。Objective: This study is to evaluate the efficacy of TACE in the treatment of hepatocellular carcinoma with tumorthrombus in the portal vein. Materials and Methods: 59patients of HCC with portal vein thrombus (29 in the trunk, 30 in the first branch)underwent TACE treatment. Patients were divided into 3 gnups according to the method of TACE: GS group(n = 21), LP group(n = 10),Mixed group(n = 28). Shrink of tumor thrombus and survival time were recorded as index to evaluate the short - term and long - term effectrespehvely. Effective and non - effective groups were divided according to short - term effect. Result : The short - term effective rate of 3groups were 38. 1 %, 0%and 50% respectively. GS and Mixed group were better than LP poup(P < 0. 05). The effective rates of TACE toshrink of thrombus were 50%, 5. 7%and 24. 1 % in GsTACE, LpTACE and LpGsTACE respectively. Efficacy of GsTACE was superiorto the latter two methods(p < 0. 05). Mited gmup was higher than the other two in the long - term effect(p < 0. 05),whose 3 -, 6 -, 12 month cumulaive survival rate was 89. 2%, 52.0%, 18. 6% respectively.The 3 -, 6 -, 12 - month survival rate was 100%, 59. 1%,19. 8% in detive group,which had significant difference with non - effective group(p < 0. 01). Conclusion: In the treatment of HCC withtumor thrombus in the portal vein, TACE with Gs was superior to TACE without Gs. GsTACE should be the first choice of dealing with patients of HCC with tumor tbos in the pond vein.

关 键 词：肝肿瘤 门脉 瘤栓 明胶海绵 治疗 

分 类 号：R735.7[医药卫生—肿瘤]