肝动脉栓塞化疗治疗原发性肝癌疗效观察（附92例报告）

Therapeutic efficacy of transcather arterial chemoembolization for hepatic carcinoma and its influence on hepatic function：a retrospective study of 92 patients

目的探讨TACE治疗原发性肝癌的疗效及其对肝功能的影响。方法HCC患者依治疗次数分为3组，以生存率和治疗前后肿瘤大小及AFP变化评估TACE疗效，通过比较肝功能相关指标（ALT、AST、ALB、DBLI、TBLI、PT）治疗前后的变化评估TACE治疗对肝功能的影响。结果3个组的肿瘤缩小有效率分别为4．3％、23．1%、31．6％（P〈0．05）；组1和组2患者肝功能参数治疗前后差异无统计学意义（P〉0．05），组3患者肝功参数皆出现不可逆性损害，和术前比较差异有统计学意义（P〈0．05）；3个治疗组1年、2年、3年生存率分别为27．0％、10．8％、5．4％，57．1％、33．3％、19．0％和62．5％、37．5％、18．8％，组2和组3的生存率比较差异无统计学意义（P〈0．05）.结论（1）3～4次TACE治疗可明显改善HCC患者长期生存率；（2）治疗引起的对肝功能的不可逆性损害可抵消TACE的部分疗效.

Objective To evaluate the therapeutic efficacy of transcather arterial chemoembolization for hepatic carcinoma and its influence on hepatic function. Methods Patients with HCC were divided into three groups according to repeated TACE times. The therapeutic efficacy was assessed with survival rate,carcionma size and biologic response （AFP）. Hepatic function was evaluated according to some hepatic parameters（ALT,AST,ALB,DB,TB,PT）. Results All three groups responses rates were 4.3% , 23. 1% and 31.6% ; srespectively, liver function in group 1 and group 2 returned to its pretreatment level （P 〈 0.05 ）, but in group 3, liver function did not return to its pretreatment level associated with more repeated TACE times. The 1-,2- and 3-year survival rates of group 1 were 27.0% , 10.8% , 5.4% ; respectively, while those of group 2 were 57.1%, 33.3% , 19.0% ; respectively, which were not significantly different from those of Team 3 ,which was 62.5% , 37.5% , 18.8% , respectively. Conclusions （ 1 ） three to four repeated times TACE was an effective palliative treatment that prolongs survival of patients with HCC ,while 1 to 2 repeated times had a limited benefit; （2） Irreversible hepatic impairment induced by TAEC could affect its therapeutic efficacy.