不同影像学类型巨块型肝癌TACE疗效分析  

The Efficacy after TACE of Massive Hepatocarcinoma with Different Imaging Appearance

作　　者：王承恩[1] 孙成建[1] 解玲玲[1] 王彦华[1] 

机构地区：[1]青岛大学附属医院介入科,山东青岛266003

出　　处：《中国普外基础与临床杂志》2014年第10期1254-1258,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨不同影像学类型巨块型肝癌肝动脉化疗栓塞术(TACE)的治疗效果及其机理。方法回顾性分析笔者所在医院2008年1月至2012年1月期间行TACE治疗的38例巨块型肝癌患者的影像学资料,根据TACE治疗前肿瘤边缘情况将其分为边缘清晰组和边缘模糊组,评价2组患者TACE治疗后碘油沉积情况及6个月后肿瘤缓解情况。结果术前2组患者的HbsAg及AFP阳性者和Child-Pugh分级情况,以及肿瘤最大直径和碘油用量的差异均无统计学意义(P>0.05)。TACE后6个月CT复查示,边缘清晰组和边缘模糊组肿瘤最大直径分别为(8.2±1.48)cm和(12.2±1.67)cm,前者小于后者(P<0.05)。碘油沉积情况,边缘清晰组主要是Ⅰ型和Ⅱ型,无Ⅲ、Ⅳ型;而边缘模糊组Ⅰ型者少,主要是Ⅱ、Ⅲ型,部分Ⅳ型者,2组间差异有统计学意义(P<0.05)。边缘清晰组的总有效率(CR+PR)为92.9%,边缘模糊组的总有效率(CR+PR)为62.5%,前者高于后者(P<0.05)。术后2组患者并发症发生情况差异无统计学意义(P>0.05)。结论在CT图像中,边缘清晰的巨块型肝癌TACE术后碘油沉积情况及疗效均优与边缘模糊者。Objective To investigate the clinical efficacy and mechansim of massive hepatocarcinoma with different imaging appearance after transcatheter arterial chemoembolization(TACE). Methods The image data of 38 patients with massive hepatocarcinoma were collected and analized retrospectively. According to the tumor edge situation on CT images before TACE treatment, the patients were divided into two groups:the sharp-edged tumor group and indistinct-edged tumor group. The effi cacy were evaluated according to the imaging appearance after treatment. Results The differences of the positive cases of HbsAg and AFP, Child-Pugh class, maximum tumor diameter, and dosage of lipiodol between the two groups before procedure were not statistic signifi cance(P>0.05). Six months after TACE, the maximum tumor diameter of the sharp-edged tumor group and indistinct-edged tumor group was(8.2±1.48) cm and(12.2±1.67) cm, respectively, the difference between the two groups was statistic signifi cance(P<0.05). In accordance with lipiodol deposition, Ⅰ and Ⅱ type were found in the sharp-edged tumor group without Ⅲ and Ⅳ type. Most were Ⅱ and Ⅲ type with less Ⅰ type and several Ⅳ type in the indistinct-edged tumor group. According to the size of tumor six months after TACE, the total effective rate(CR+PR) was 92.9% and 62.5%, respectively in the sharp-edged tumor group and indistinct-edged tumor group. There were signifi cantly difference between the two groups in iodized oil distribution and tumor size after procedure(P<0.05). No statistical difference was found between the incidence rate of complications in two groups(P>0.05). Conclusion The effi cacy of massive hepatocarcinoma in patients with sharpedged tumor on CT images is better than those with indistinct-edged tumor.

关 键 词：巨块型肝癌 假包膜 化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]