手术切除与经导管动脉栓塞化疗治疗肝细胞癌合并门静脉癌栓疗效的meta分析  

Meta-analysis of surgical resection and transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma complicated with portal vein tumor thrombus

作　　者：李凯[1] 郭昊苏 杨易戎 李星悦 贺康丽 刘宏[2] LI Kai;GUO Hao-su;YANG Yi-rong;LI Xing-yue;HE Kang-li;LIU Hong(Shanxi Medical University,Shanxi Taiyuan 030000,China;Department of Hepatobiliary Surgery,First Hospital of Shanxi Medical University,Shanxi Taiyuan 030000,China)

机构地区：[1]山西医科大学,山西太原030000 [2]山西医科大学第一医院肝胆外科,山西太原030000

出　　处：《中国医刊》2020年第4期401-405,共5页Chinese Journal of Medicine

摘　　要：目的探讨手术切除与经导管动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗肝功能为Child A-B级的肝细胞癌合并门静脉癌栓的临床效果。方法检索2010年7月1日至2019年7月1日中国知网、万方数据库、PubMed、Web of Science中关于采用手术切除和TACE治疗肝细胞癌合并门静脉癌栓的临床对照试验,用RevMan 5.3软件进行meta分析。结果共纳入4篇文献,共计1129例患者,其中TACE组702例,手术切除组427例。Meta分析结果显示,手术切除组的1、2、3年生存率均明显高于TACE组(P<0.01),而5年生存率两组比较差异无显著性(P>0.05)。结论肝功能为Child A-B级的肝细胞癌合并门静脉癌栓患者采用手术切除治疗的生存率在一定程度上高于TACE治疗,适合在有条件的大型肝脏外科中心开展。Objective To investigate the clinical effect of surgical resection and transcatheter arterial chemoembolization(TACE) in the treatment of hepatocellular carcinoma(HCC) complicated with portal vein thrombus with hepatic function of Child grade A-B. Method The controlled clinical trials of surgical resection and TACE in the treatment of hepatocellular carcinoma with portal vein cancer thrombus in CNKI, Wanfang database, PubMed and The Web of Science from July 1, 2010 to July 1, 2019, and the RevMan 5.3 software was used for meta-analysis. Result A total of 1129 patients were included in 4 literatures, including 702 patients in the TACE group and 427 patients in the surgical resection group. The results of meta-analysis showed that the 1-year, 2-year and 3-year survival rates of the surgical resection group were significantly higher than that of the TACE group(P<0.01), while the 5-year survival rates of the two groups showed no significant difference(P>0.05). Conclusion The survival rate of hepatocellular carcinoma with hepatic function of Child grade A-B combined with portal vein thrombus after surgical resection is higher than that of TACE treatment to a certain extent, and it is suitable to carry out in large liver surgery centers with conditions.

关 键 词：肝细胞癌 门静脉癌栓 手术切除 经导管动脉栓塞化疗 

分 类 号：R735.7[医药卫生—肿瘤]