辅助性TACE对腹腔镜解剖性肝切除术后肝癌患者早期肝纤维化的影响  

Effect of adjuvant TACE on early liver fibrosis in patients with hepatocellular carcinoma after laparoscopic anatomic hepatectomy

作　　者：成剑[1] 张成武[1] 刘杰[1] 窦常伟 江恺[1] CHENG Jian;ZHANG Chengwu;LIU Jie;DOU Changwei;JIANG Kai(Department of General Surgery/Cancer Center,Department of Hepatobiliary&Pancreatic Surgery/Minimally Invasive Surgery,Zhejiang Provincial People’s Hospital/Affiliated People’s Hospital of Hangzhou Medical College,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院/杭州医学院附属人民医院普通外科/癌症中心/肝胆胰外科/微创外科,浙江杭州310014

出　　处：《肝胆胰外科杂志》2022年第12期723-726,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨辅助性经导管动脉化疗栓塞(TACE)对腹腔镜解剖性肝切除(LAH)术后肝细胞癌(HCC)患者早期肝纤维化的影响。方法回顾性分析浙江省人民医院2019年6月至12月接受LAH的HCC患者20例,比较LAH术前与LAH术后1个月、辅助性TACE术后1个月血清肝纤维化四项指标即层粘连蛋白(LN)、透明质酸(HA)、三型前胶原(PCⅢ)和四型胶原(CⅣ)水平,分析辅助性TACE对LAH术后HCC患者早期肝纤维化的影响。并统计患者的早期(2年)无复发生存期(RFS)与总生存期(OS)。结果同LAH术前相比,LAH术后1个月血清肝纤维化指标无统计学差异,而辅助性TACE术后1个月血清PCⅢ[(53.4±20.8)ng/mL vs(34.3±14.2)ng/mL,P<0.01)]和CⅣ[(45.2±22.9)ng/mL vs(29.7±10.4)ng/mL,P<0.01]水平显著增高。随访至2022年5月,患者1年和2年RFS分别为75%和55%,2年OS为75%。结论辅助性TACE可能会加重LAH术后HCC患者近期肝纤维化增生。Objective To explore the effect of adjuvant transcatheter arterial chemoembolization(TACE)on early liver fibrosis in patients with hepatocellular carcinoma(HCC)after laparoscopic anatomic hepatectomy(LAH).Methods The clinical data of twenty patients diagnosed as HCC and underwent LAH in Zhejiang Provincial People’s Hospital from Jun.2019 to Dec.2019 were retrospectively analyzed.The serum indexes of liver fibrosis including laminin(LN),hyaluronic acid(HA),type III procollagen(PCⅢ)and typeⅣcollagen(CⅣ)on the pre-operation,one month after LAH and one month after adjuvant TACE were compared.The effect of adjuvant TACE after LAH on early liver fibrosis were investigated.Short-term(2-year)recurrencefree survival(RFS)and overall survival(OS)were calculated.Results Compared with the pre-operative results,there were not significant differences on the liver fibrosis indexes of serum one month after LAH,whereas the levels of serum PCⅢ[(53.4±20.8)ng/mL vs(34.3±14.2)ng/mL,P<0.01]and CⅣ[(45.2±22.9)ng/mL vs(29.7±10.4)ng/mL,P<0.01]were significantly increased one month after adjuvant TACE.All patients were followed until May 2022.The 1-and 2-year RFS were 75%and 55%,respectively,and the 2-year OS was 75%.Conclusion Adjuvant TACE may aggravate early liver fibrosis and hyperplasia after LAH in HCC patients.

关 键 词：肝纤维化 肝细胞癌 腹腔镜肝切除术 经导管动脉化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤] R657.3[医药卫生—临床医学]