载药微球经导管肝动脉化疗栓塞治疗肝脏恶性肿瘤研究进展  

Research progress on transcatheter arterial chemoembolization with drug-eluting bead for liver malignant tumors

作　　者：王玉峰 何东风[1] Wang Yu-Feng;He Dong-Feng(Department of Interventional Therapy,Affiliated Cancer Hospital of Harbin Medical University,Harbin 150006,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院介入科,哈尔滨150006

出　　处：《解放军医学杂志》2022年第5期524-532,共9页Medical Journal of Chinese People's Liberation Army

摘　　要：肝癌是目前临床上常见的消化系统恶性肿瘤,包括原发性肝癌与继发性肝癌,原发性肝癌主要分为肝细胞癌与胆管细胞癌,继发性肝癌则多源于结直肠癌的肝转移。肝癌的治疗手段包括手术切除、肝移植、消融治疗、经导管肝动脉化疗栓塞(TACE)、经肝动脉化疗灌注、靶向治疗及免疫治疗等。根据巴塞罗那分期(BCLC)及中国《原发性肝癌诊疗规范(2019年版)》,TACE可作为无法手术切除的中期肝细胞癌患者的首选治疗方案。随着载药微球的兴起与发展,载药微球-TACE(D-TACE)开始在各个分期的肝癌治疗中崭露头角。本文就TACE尤其是D-TACE在肝细胞癌、胆管细胞癌及肝转移瘤中的应用,TACE与其他治疗方式的临床获益及不良反应,以及TACE治疗后的肿瘤复发和影响预后的分子机制进行综述。Liver cancer is a common malignant tumor of digestive system,including primary liver cancer and secondary liver cancer.Primary liver cancer can be divided mainly into hepatocellular carcinoma and cholangiocarcinoma,and secondary liver cancer mostly comes from liver metastasis of colorectal cancer.The treatment of liver cancer include surgical resection,liver transplantation,ablation,transcatheter arterial chemoembolization(TACE),transcatheter arterial chemoperfusion,targeted therapy and immunotherapy.According to Barcelona staging(BCLC)and China's code for the diagnosis and treatment of primary liver cancer(2019 Edition),TACE can be used as the first choice for patients with unresectable medium-term hepatocellular carcinoma.With the rise and development of drug-eluting bead,drug-eluting bead TACE(D-TACE)began to emerge in the treatment of various stages of liver cancer.The application of TACE,especially D-TACE in hepatocellular carcinoma,cholangiocarcinoma and liver metastasis,comparison of the clinical benefits and adverse reactions with other treatment methods,and the molecular mechanisms of tumor recurrence and prognosis after TACE treatment have been focused and summarized in present paper.

关 键 词：肝细胞癌 胆管细胞癌 肝转移瘤 经导管肝动脉化疗栓塞 载药微球 

分 类 号：R735.7[医药卫生—肿瘤]