介入治疗后38例中晚期肝癌患者生存5年以上的因素分析  

Clinical analysis of 38 cases of unresectable primary hepatic carcinoma survived for more than 5 years after interventional therapy

作　　者：周泽健[1] 罗鹏飞[1] 邵培坚[1] 陈晓明[1] 张良明[1] 李伟科[1] 李勇[1] 许荣德[1] 庄文行[1] 张华[1] 

机构地区：[1]广东省人民医院肿瘤科,广州510080

出　　处：《中华放射学杂志》2002年第9期792-796,共5页Chinese Journal of Radiology

摘　　要：目的　探讨中晚期肝癌介入治疗远期疗效的影响因素。方法　从 1988年 5月至1996年 4月 ,对 6 6 0例肝癌行动脉碘油药物乳剂栓塞化疗 (LP TACE) ,其中 6 3例尚行经皮无水乙醇消融治疗 (PEI)。 6 6 0例中 ,96例获病理确诊。临床分期为临床Ⅱ期 5 4 3例 ,Ⅲ期 117例 ;肿瘤分型为单结节型 171例 ,多结节型 6 7例 ,巨块型 388例 ,弥漫型 34例 ;肿瘤瘤径≤ 10cm者 2 5 6例 ,>10cm者4 0 4例 ;动脉造影为富血型 5 38例 ,乏血型 12 2例 ;甲胎蛋白 (AFP) <2 0 μg/L者 4 73例 ,>2 0 μg/L者187例 ;肝功能A级 4 30例、B级 16 4例、C级 6 6例。 6 6 0例共行LP TACE 176 5次 (平均 2 7次 ) ,其中6 3例共行PEI 16 5次 (平均 2 6次 )。介入治疗后生存 5年以上者 38例 ,其中 8例获得病理证实。 6 6 0例均进行随访 ,失访者按失访日期作为死亡时间统计。着重就生存 5年以上 38例的情况行回顾性分析。结果　 38例肝癌生存 5年以上 ,其中生存超过 7年 14例 ,超过 10年 6例 (2例至今分别已生存了13年 6个月、13年 3个月 ) ;5、7、10年的生存率分别为 5 8% (38/ 6 6 0 )、2 1% (14 / 6 6 0 )、0 9% (6 / 6 6 0 )。38例中 ,临床分期均为Ⅱ期 ;肿瘤分型为单结节型 2 0例 ,多结节型 8例 ,巨块型 10例 ,弥漫型 0例 ;肿瘤瘤径?Objective To investigate the affecting factors on long term effect of interventional therapy for unresectable primary hepatic carcinoma (PHC). Methods From May 1988 to April 1996, 660 cases of unresectable PHC were treated with lipiodol transcatheter hepatic artery chemoembolization (LP TACE), 63 cases of them also received percutaneous ethanol injection (PEI). Of the 660 cases, 96 cases were proved by pathology. The clinical stage included stage Ⅱ (543 cases) and stage Ⅲ (117 cases). The tumor pattern included mononodular type (171 cases), multinodular type (67 cases), large lesion type (388 cases), and diffuse type (34 cases). The angiographic findings included hypervascular type (538 cases) and hypovascular type (122 cases). 473 cases had AFP<20 μg/L and 187 cases had AFP>20 μg/L. According to the liver function (Child′s system), 430 cases belonged to grade A, 164 cases grade B, and 66 cases grade C. 660 cases underwent LP TACE for 1765 times (mean 2 7 times) and 63 cases received PEI for 165 times (mean 2 6 times). Of the 38 cases survived more than 5 years after interventional therapy, 8 cases were demonstrated by pathology. All the 660 cases were followed up for more than 5 years and 38 cases were analyzed retrospectively and concentratively. Results 38 cases of unresectable PHC survived more than 5 years after interventional therapy. Among them, 14 cases survived for more than 7 years and 6 cases survived for more than 10 years. The survival rate of 5, 7, and 10 years was 5 8%(38/660), 2 1%(14/660), and 0 9%(6/660), respectively. 2 cases had survived for more than 13 years up to now. All the 38 cases were in clinical stage Ⅱ, and the tumor pattern included mononodular type (20 cases), multinodular type (8 cases), large lesion type (10 cases), and diffuse type (0 cases). All these 38 cases were hypervascular type angiographically. AFP<20 μg/L was found in 18 cases, and >20 μg/L in 20 cases. The liver function included grade A in 29cases, grade

关 键 词：介入治疗 中晚期肝癌 肝肿瘤 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]