经皮肝穿刺门静脉灌注IL-Ⅱ治疗PVTT的临床意义

THE EFFECT OF PERCUTANEOUS TRANSHEPATIC PORTAL VEIN PERFUSION IL-Ⅱ THERAPIES FOR HEPATOCELLULAR CARCINOMA WITH TUMOR THROMBUS OF PORTAL VEIN

目的 :评价门静脉灌注白细胞介素 - (IL- )治疗门静脉癌栓 (PVTT)的治疗效果。方法 :病例随机分为治疗组及对照组 ,治疗组 31例 ,将 IL- 10 0万单位用 10 ml生理盐水稀释后在 B超引导下注射到门静脉癌栓部位 ,每周 1次 ,3次为 1个疗程 ,每月 1个疗程 ,共 3个疗程。对照组 32例 ,门静脉癌栓部位注射生理盐水 10 m l,同时用顺铂 2 0 mg全身化疗 ,每周 1次 ,3次为 1个疗程 ,每月 1个疗程 ,共 3个疗程。结果 :治疗组癌栓消融及减低门静脉压力总有效率为 (CR、PR、NR) 96 .7% ,明显高于对照组 5 0 %。治疗组生存时间也明显优于对照组。另外 ,治疗组有 3例获 期切除 ,而对照组无一例。结论 :虽然 B超引导下经皮肝穿刺门静脉灌注 IL- 治疗 PVTT有部分患者疗效不显著及有出现肝内播散及远处转移的可能 ,但总的来说 ,大部分患者延长了生存时间 ,提高了生存质量 ,开扩了肝癌综合治疗的方法 ,并且由于其创伤小 ,可重复进行治疗等优点 ,我们认为其不失为一个治疗

Objective:To evaluate the therapeutic efficacy of percutaneous transhepatic portal vein perfusion IL Ⅱtherapies for hepatocellular carcinoma with tumor thrombus of portal vein.Methods:The cases were randomly divided into two groups.The treatment group had 31 cases and the control 32 cases.Under the guidance of ultrasound ,all patients of the treatment group were perfusied with 1×106u of interleukin Ⅱ dilution in 10 ml of 0 9% sodium chloride into the tumor embolus of the portal vein,3 times a month as a course, and were treated for 3 courses. The control group had perfusion 10ml of 0 9% sodium chloride into the tumor embolus of the portal vein, and at the same time, ivgtt 20mg cisplatin simultaneously, 3 times a month as a course, and for 3 courses.Result:The efficiency(CR?PR?NR) rate on the cancer embolus ablation and the reduction of the portal vein pressure in the treatment group was 96 7%,significantly higher than the control group(50%).The survival time of the treatment group was much longer than the control group. In addition, 3 cases in the treatment group had two stage resection, but none in the control group.Conclusion:Though the result of some patients was dissatisfactorg and may cause metastasis, the overall effect of most patients had a longer survival time and improved life quality after being treated by this technic. This method has the virtue of little wound and reccurence. so we conclude that it will be an effective measure for treatment of tumor thrombus of portal vein.