微粒TACE联合肝移植治疗肝细胞癌伴Ⅱ、Ⅲ型门静脉癌栓安全性及疗效  

Safety and efficacy of GSMS-TACE plus liver transplantation for hepatocellularcarcinoma with type Ⅱ、Ⅲ portal vein tumor thrombus

作　　者：杨世伟[1] 刘影 韩东冬[1] Yang Shireei;Liu Ying;Han Dongdong(Beijing Tsinghua Changgumg Hospital,School of Clinical Medicine,Tsinghua Umiversity,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院清华大学临床医学院,北京102218

出　　处：《中华器官移植杂志》2020年第7期412-416,共5页Chinese Journal of Organ Transplantation

基　　金：北京市医管局扬帆计划(ZYLX201712)。

摘　　要：目的初步观察应用明胶海绵微粒肝动脉化疗栓塞(GSMs-TACE)联合同种异体原位肝移植治疗肝癌合并Ⅱ、Ⅲ型门静脉癌栓患者的安全性及临床疗效。方法回顾性分析2018年1月至2018年6月清华大学附属北京清华长庚医院行GSMs-TACE联合肝移植的7例肝癌伴Ⅱ或Ⅲ型癌栓受者。术后结合肿瘤标记物、影像学检查、术后并发症、生存时间综合评估安全性及临床疗效。结果中位随访24个月,受者术前平均行介入的次数为1.5次,术后无胆瘘、腹腔出血、肝肾功能衰竭、动脉狭窄、胆道狭窄等并发症发生。所有受者GSMs-TACE术后肿瘤及癌栓均有不同程度坏死;5例受者GSMs-TACE术后甲胎蛋白较术前下降,7例受者异常凝血酶原较术前下降。7例受者目前均存活,1年存活率为100%,1年无瘤生存率为71.4%。2例受者出现肺转移,复发时间分别为4个月与10个月。结论 GSMs-TACE联合肝移植治疗肝细胞癌合并门静脉癌栓受者,具有一定的临床疗效及良好的安全性。Objective To explore the safety and clinical efficacy of orthotopic liver transplantation after treatment with gelatin sponge microparticles by transcatheter arterial chemoembolization(GSMs-TACE)for hepatocellular carcinoma with type II/III portal vein tumor thrombus.Methods For this retrospective study,patients with hepatocellular carcinoma with portal vein tumor thrombosis undergoing GSMs-TACE before liver transplantation from January 2018 to June 2018.The clinical efficacy and safety were evaluated by alpha feto-protein(AFP),imaging changes,postoperative complications and survival time.Results The median follow-up period was 24 months.The average number of GSMs-TACE was 1.5.No postoperative complications such as biliary fistula,abdominal hemorrhage,liver and kidney failure,arterial stenosis and biliary stricture occurred.After GSMs-TACE,there were varying degrees of tumor necrosis or thrombus,AFP decreased(n=5)and PIVKAII declined(n=7).The 1-year survival rate was 100%and the 1-year disease-free survival rate 71.4%.For two cases of lung metastasis,the recurrent time was 4 and 10 months respectively.Conclusions GSMs-TACE plus liver transplantation offer good safety and clinical efficacy for hepatocellular carcinoma patients with portal vein cancer thrombus.

关 键 词：肝移植 肝癌 介入治疗 

分 类 号：R735.7[医药卫生—肿瘤]