肝动脉栓塞术后Ⅱ期肝癌切除（附10例切除标本的病理研究）

Resection of Hepatocellular Carcinoma Following Transcatheter Hepatic Artery Embolization

笔者报告了１０例肝恶性肿瘤经肝动脉栓塞术后Ⅱ期切除，其中有４例患者在栓塞前无手术适应证。所有切除标本均进行了详细的病理研究。结果表明：３例肿瘤１００％坏死，其余坏死率为７５％～９０％。肿瘤卫星灶、门静脉瘤栓及包膜内浸润癌细胞均有不同程度坏死。另一显著所见是肿瘤包膜明显增厚。术后平均生存率和中位生存率分别为２４．８和２４．５个月。笔者认为：肝动脉栓塞术是将手术不能切除的大肝癌转化为可切除的有效方法；栓塞术至手术的间隔时间以３个月以上为最佳。笔者还对肿瘤栓塞后的病理变化进行分期，对手术可切除肝癌的术前栓塞的价值进行了探讨。

This article was a retrospective review of 10 cases of hepatocellular carcinoma(HCC)resected after transcather hepatie artery embolization. 4 patients were considered to be inop-erable prior to embolotheray. Pathological study revealed no viable tumor cells in 3 cases and exten-sive necrosis(70%～95%)in the remaining 7. Various degrees of necrosis were found in the satellite lesions tumor thrombus in the portal vein and the infiltrating tumor cells in the capsule,5 cases showed marked thickening of the capsule. The mean and median survival times were 24. 8 and 24.5 months respectively. The authors were of the opinion that hepatic artery embolization was an effec-tive method which might convert an unresectable HCC into a resectable one.The interval between embolization and operation was preferably more than 3 months. A modified histopathologic classifica-tion after embolization was suggested and evaluation of embolotherapy as a pre-operative procedure was investigated.