TACE联合门静脉支架置放术治疗原发性肝癌合并门静脉癌栓的疗效  

Efficacy of TACE Combined with Portal Vein Stent in Treatment of Primary Liver Cancer with Portal Vein Tumor Thrombus

作　　者：刘燕[1] 张铭光[1] 唐莉[1] 罗薛峰[1] Liu Yan;Zhang Mingguang;Tang Li;Luo Xuefeng(West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《北华大学学报（自然科学版）》2019年第3期337-340,共4页Journal of Beihua University（Natural Science）

基　　金：国家自然科学基金项目(81501566)

摘　　要：目的分析肝动脉化疗栓塞(TACE)联合门静脉支架置放术治疗原发性肝癌合并门静脉癌栓(PVTT)的疗效及安全性.方法回顾性分析原发性肝癌合并PVTT患者74例,其中35例行单纯TACE治疗(TACE组),39例行TACE联合门静脉支架置放术(联合组),比较两组治疗后肝功能、肝癌活性指标,应用Kaplan-Meier法进行生存分析,并观察两组不良反应.结果治疗后8周,联合组血清谷丙转氨酶(ACT)、谷草转氨酶(AST)、直接胆红素(DBIL)、总胆红素(TBIL)及甲胎蛋白异质体(AFP-L3)、E钙粘连蛋白(EC)、血管内皮生长因子(ICAM-1)、细胞间黏附分子水平均明显低于TACE组(P<0.05).联合组中位生存时间为6.7个月,明显长于TACE组的4.4个月(P<0.05);联合组1 a生存率为10.26%,明显高于TACE组的0.00%(P<0.05).两组均无手术相关性死亡及严重并发症发生,且治疗后主要不良反应发生率比较差异无统计学意义(P>0.05).结论 TACE联合门静脉支架置放术治疗原发性肝癌合并PVTT可有效延长患者生存期,且安全性较好.Objective To analyze the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with portal vein stent in the treatment of primary liver cancer with portal vein tumor thrombus(PVTT).Method 74 patients with primary liver cancer complicated with PVTT were retrospectively analyzed,35 patients was treated with TACE alone(TACE group),39 patients was treated with TACE combined with portal vein stent placement(combined group).The liver function and liver cancer activity indexes of the two groups after treatment were compared,the survival analysis was performed by Kaplan-Meier method,the adverse reactions of the two groups were observed.Results At 8th week after treatment,the levels of serum alanine aminotransferase(ACT),glutamic oxalacetic transaminase(AST),direct bilirubin(DBIL),total bilirubin(TBIL),alpha-fetoprotein heterogene(AFP-L3),Ecadherin(Ec),vascular endothelial growth factor(VESF)and intercellular adhesion molecule(ICAM-1)of the combined group were significantly lower than those of the TACE group(P<0.05).The median survival time was 6.7 months in the combined group,significantly longer than 4.4 months in TACE group(P<0.05).The 1-year survival rate was 10.26%in the combined group,significantly higher than 0.00%in TACE group(P<0.05).There were no surgical-related deaths and serious complications in the two groups,there was no significant difference in the incidence of major adverse reactions after treatment(P>0.05).Conclusion TACE combined with portal vein placement for the treatment of primary liver cancer with PVTT can effectively prolong the survival of patients,and the safety is good.

关 键 词：原发性肝癌 门静脉癌栓 肝动脉化疗栓塞 门静脉支架置放术 

分 类 号：R735.7[医药卫生—肿瘤]