介入联合索拉菲尼治疗肝癌伴门脉癌栓的疗效观察  

Therapeutic Effect of Intervention Combined with Sorafenib in the Treatment of Hepatocellular Carcinoma with Main Portal Vein Tumor Thrombus

作　　者：丁丁[1] 付守忠[2] 戴锋[2] 丁苇[2] 薛红 王斌[2] 王晓维[2] 殷梦杰 沈建东[2] 张勤[4] DING Ding;FU Shouzhong;DAI Feng;DING Wei;XUE Hong;WANG Bin;WANG Xiaowei;YIN Mengjie;SHEN Jiandong;Zhang Qin(Department of Imaging,Affiliated Nantong Hospital 3,Nantong University;Department of Intervention,Affiliated Nantong Hospital 3,Nantong University,Nantong 226001,China;Department of Hepatology,Affiliated Nantong Hospital 3,Nantong University;Department of Imaging,Affiliated Maternal and Child Health Hospital,Nantong University)

机构地区：[1]江苏省南通大学附属南通第三医院影像科,南通226001 [2]江苏省南通大学附属南通第三医院介入科 [3]江苏省南通大学附属南通第三医院肝病科 [4]江苏省南通大学附属妇幼保健院影像科

出　　处：《中国医学计算机成像杂志》2023年第4期433-437,共5页Chinese Computed Medical Imaging

基　　金：江苏省卫生健康委员会科研基金(Z2022054)。

摘　　要：目的:探讨肝动脉化疗栓塞(TACE)序贯索拉非尼联合门静脉支架及碘125粒子链治疗原发性肝癌合并门静脉主干癌栓的临床疗效。方法:选取40例肝细胞癌伴门静脉主干癌栓患者,按随机数字表法分为观察组和对照组(各20例),观察组予TACE序贯索拉非尼联合门静脉支架及碘125粒子链治疗,对照组予TACE联合门静脉支架及碘125粒子链治疗。对比观察组和对照组患者治疗前后血清异常凝血酶原(DCP/PIVKA-Ⅱ)、甲胎蛋白(AFP)水平、近期疗效、36个月生存情况。结果:观察组治疗后的总体有效率为90%,对照组为55%,2组差异有统计学意义(P<0.05);治疗后2组血清PIVKA-II、AFP水平均低于各自治疗前的水平,且观察组明显低于对照组,差异有统计学意义(P<0.05);观察组和对照组中位生存时间分别为20个月和11个月,观察组的生存结局优于对照组(P<0.05)。结论:TACE序贯索拉非尼联合门静脉支架及碘125粒子链治疗肝细胞肝癌伴门静脉主干癌栓,可延长患者生存时间,具有良好的临床应用前景。Purpose:To investigate the clinical effect of hepatic arterial chemoembolization(TACE)combined with portal vein stents and iodine-125 particle chain sequential sorafenib in the treatment of hepatocellular carcinoma complicated with main portal vein tumor thrombus.Methods:Forty patients with hepatocellular carcinoma complicated with main portal vein tumor thrombus were selected and divided into observation group and control group(20 cases each).The observation group was treated with TACE sequential sorafenib combined with portal vein stent and iodine-125 particle chain,and the control group was treated with TACE combined with portal vein stent.Serum des-γ-carboxy-prothrombin(DCP/PIVKA-Ⅱ),AFP levels,short-term efficacy and 36 months survival were compared between the observation group and the control group before and after treatment.Results:The overall effective rate was 90%in the observation group and 55%in the control group(P<0.05).After treatment,the serum PIVKA-Ⅱand AFP levels of the two groups were lower than those before treatment,and the observation group was significantly lower than the control group,with a statistically significant difference(P<0.05).The median survival time of the observation group and control group was 20 months and 11 months,respectively.The survival outcome of the observation group was better than that of the control group(P<0.05).Conclusion:TACE sequential sorafenib combined with portal vein stent and iodine-125 particle chain in the treatment of primary hepatocellular carcinoma complicated with main portal vein tumor embolus can significantly prolong the survival time,and has a good clinical application prospect.

关 键 词：肝癌 碘125粒子 门静脉支架 肝动脉栓塞化疗 索拉菲尼 

分 类 号：R816.5[医药卫生—放射医学]