经导管动脉化疗栓塞术联合经皮穿刺瘤内注射碘油化疗药物乳剂治疗无法切除外生型肝癌的临床观察  

Clinical observation of transcatheter arterial chemoembolization combined with percutaneous intratumoral injection of chemotherapeutic agents lipiodol emulsion in the treatment of unresectable pedunculated hepatocellular carcinoma

作　　者：林培超 李红兵 曾庆乐[3] 郑泽海 黄得校[1] 陈勇[3] LIN Peichao;LI Hongbing;ZENG Qingle;ZHENG Zehai;HUANG Dexiao;CHEN Yong(Department of Medical Imaging,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Department of Radiology,Shenzhen Fuyong People’s Hospital,Shenzhen 518103,China;Department of Interventional Radiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]汕头大学医学院第二附属医院医学影像中心,广东汕头515041 [2]深圳市宝安区福永人民医院放射科,广东深圳518103 [3]南方医科大学南方医院介入治疗科,广东广州510515

出　　处：《汕头大学医学院学报》2020年第4期230-234,共5页Journal of Shantou University Medical College

基　　金：广东省医学科学技术研究基金(B2017004)。

摘　　要：目的:探讨经导管动脉化疗栓塞术(TACE)联合经皮穿刺瘤内注射碘油化疗药物乳剂(CALE)治疗无法切除外生型肝癌的疗效和安全性。方法:回顾性分析2003—2014年南方医科大学南方医院和汕头大学医学院第二附属医院25例经影像学或病理学证实且无手术切除指征的外生型肝癌患者,均接受TACE联合经皮瘤内注射CALE治疗,其中男性23例,女性2例;年龄19~70岁,平均(50.3±12.3)岁。肿瘤最大直径为(9.1±3.9)cm。采用Kaplan-Meier法分析生存率,采用Cox比例风险回归模型进行生存率影响因素分析。结果:25例患者1、2、3、5年生存率分别为78.9%、52.6%、42.1%和12.0%,中位生存期为27个月(95%CI:22.6~43.2)。血管侵犯(HR=22.454,95%CI:3.358~150.127)与局部淋巴结转移(HR=8.144,95%CI:1.436~46.178)是无法切除外生型肝癌患者生存的不良预后因素。结论:TACE联合经皮穿刺瘤内注射CALE治疗无法切除外生型肝癌是一种安全有效的方法。Objective:To investigate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with percutaneous intratumoral injection of chemotherapeutic agents lipiodol emulsion(CALE)in the treatment of unresectable pedunculated hepatocellular carcinoma.Methods:From 2003 to 2014,25 patients with unresectable pedunculated hepatocellular carcinoma confirmed by imaging or pathology and without surgical resection indications were retrospectively analyzed,including 23 males and 2 females with an average age of(50.3±12.3)years(range,19-70 years).The maximum diameter of the tumor was(9.1±3.9)cm.Kaplan-Meier method was used to analyze the survival rate,and Cox proportional hazard regression model was used to analyze the influencing factors of survival rate.Results:The 1-,2-,3-,and 5-year survival rates were 78.9%,52.6%,42.1%and 12.0%,respectively.The median survival time was 27 months(95%CI:22.6-43.2).Vascular invasion(HR=22.454,95%CI:3.358-150.127)and local lymph node metastasis(HR=8.144,95%CI:1.436-46.178)were the poor prognostic factors for the survival of patients with unresectable pedunculated hepatocellular carcinoma.Conclusion:TACE combined with percutaneous injection of CALE is a safe and effective method for the treatment of unresectable pedunculated hepatocellular carcinoma.

关 键 词：外生型肝癌 经导管动脉化疗栓塞术 经皮穿刺瘤内注射 碘油 

分 类 号：R735.7[医药卫生—肿瘤]