经皮肝动脉化疗栓塞(TACE)对不同分型门静脉癌栓的疗效观察

Therapeutic effects of transcatheter arterial chemoembolization on different types of tumor thrombi in portal vein in patients with hepatocellular carcinoma

目的 观察经皮肝动脉化疗栓塞 (TACE)对不同分型门静脉癌栓肝癌病人的疗效。方法 2 0 0 0年 1月至 2 0 0 3年 1月 ,4 8例肝癌合并门静脉癌栓按是否接受TACE治疗分为两组 :TACE组 (n =38)和保守治疗组 (n =10 ) ,比较两组病人的生存期和不同分型门静脉癌栓的治疗效果。结果 TACE治疗组和保守组的中位生存期分别为 5 0 (4 4 ,5 6 )个月和 2 0 (1 8,2 2 )个月 ,差异有显著性 (P =0 0 0 0 0 )。Ⅰ (n =6 )、Ⅱ (n =11)、Ⅲ (n =2 0 )、Ⅳ型 (n =1)癌栓病人经TACE治疗后中位生存期分别为 12 0、5 0、4 0、3 0个月 (P =0 0 0 13)。结论 TACE对累及二级及二级以上门静脉分支癌栓 (即Ⅰ型癌栓 )疗效显著。

Objective To observe the therapeutic effects of transcatheter arterial chemoembolization (TACE) on different types of tumor thrombi in the portal vein in patients with hepatocellular carcinoma (HCC). Methods Of the 48 patients with HCC treated in our hospital from January 2000 to January 2003, 38 were treated with TACE (group A) and 10 with supporting treatment alone (group B). The median survival time and therapeutic effects on different types of tumor thrombi were determined and compared between the 2 groups. Results The median survival time was 5.0 months and 2.0 months in group A and group B, respectively. For type I to type IV tumor thrombi, the median survival time was 12.0, 5.0, 4.0 and 3.0 months, respectively. Conclusions TACE can prolong the survival time of HCC patients with tumor thrombi in the porta vein, especially those with type I tumor thrombi.