晚期肝癌伴门脉癌栓的介入治疗

Interventional Therapy in Late Hepatocellular Carcinoma with Portal Vein Cancer Embolus Formation

本文回顾性分析了19例晚期肝癌伴门脉癌栓病人的介入治疗疗效和肝动脉栓塞的安全性。结果显示19例中有13例肿瘤不同程度的缩小,全部是经加用碘油或明胶海绵栓塞肝动脉的病例。在抗癌药物加碘油、明胶海绵栓塞的肝动脉组中,9例门脉显影者仅1例 ALT 和 AST 升高,而3例门脉未显影者全部升高。因此作者认为:对伴有门脉癌栓的晚期肝癌,只要间接门脉造影显示门静脉,亦应加用碘油和明胶海绵栓塞肝动脉。但对门脉未显影者,用碘油栓塞是安全的,但不宜用明胶海绵栓塞。

Interventional therapeutic effect and the safety of hepatic artery embolization in 19 cases of hepatocelluar carcinoma with portal vein cancer embolus formation were analysed restrospectively .The results revealed that the tumors were shrinked in 13 cases with iodized oil or gelatin sponge em bolization of hepatic arteries ALT and AST levels went up in 1 case of the nine patients with partial ob struction of the main portal vein,and all of ALT and AST levels went up in all three cases with complete obstruction of the main portal veins.The author considered that the iodized oil and gelatin sponge hepatic artery embolization should be performed in late hepatocelluar carcinoma with portal vein cancer embolns when the main portal vein was shown in indirect portography.Iodized oil embolization was safety;but gelatin sponage embolization may be contraindicated in cases with the main portal vein not shown.