海藻酸钠微球联合碘化油栓塞治疗原发性肝癌的疗效分析

Efficacy of Kelp Micro Gelation Combined with Lipiodol in the Treatment of Hepatocellular Carcinoma

目的探讨海藻酸钠微球(KMG)作为栓塞剂,联合经导管肝动脉化疗栓塞术(TACE)治疗原发性肝癌的应用价值。资料与方法 2008-01～2010-03行介入治疗并经病理或实验室检查确诊的206例原发性肝癌患者,按治疗方法分为对照组和KMG组,其中对照组128例接受常规TACE治疗,KMG组78例接受常规TACE治疗+KMG栓塞,比较两组患者介入治疗后肿瘤缩小及坏死程度以及术后3个月、6个月、9个月、1年的累计生存率。结果对照组和KMG组之间的临床和病理资料差异无统计学意义(P>0.05)。206例患者中60例病变缩小30%以上,其中KMG组36例,对照组24例,两组差异有统计学意义(χ2=4.107,P<0.05)。KMG组患者治疗3个月、6个月累计生存率分别为96.1%和92.3%,而对照组分别为89.8%和87.5%,两组累计生存率差异无统计学意义(P>0.05);KMG组患者治疗9个月、1年累计生存率分别为89.7%和80.8%,而对照组分别为73.4%和57.8%,两组累计生存率差异有统计学意义(P<0.05)。结论海藻酸钠微球联合TACE栓塞治疗原发性肝癌能够增强血管栓塞效应,提高生存率,可作为肝癌介入治疗的新选择。

Purpose To analyze the value of kelp micro gelation （KMG） combined with transcatheter hepatic artery chemoembolization （TACE） in the treatment of hepatocellular carcinoma （HCC）. Materials and Methods 206 patients with HCC confirmed by pathology or laboratory tests and underwent TACE were divided into KMG group （n=78, TACE＋KMG） and control group （n = 128, TACE only）. The changes in tumor size, necrosis and the cumulative survival rates in 3 months, 6 months, 9 months and 1 year after surgery were compared. Results There was no significant difference between control group and KMG group in clinical and pathological data （P 〉 0.05）. 60 of 206 tumors shrank more than 30%, in which 36 cases were in KMG group and 24 in control group, and tumor volume reduced greater in the KMG group （χ2 = 4.107, P 〈 0.05）. The cumulative survival rates in 3 months and 6 months were 96.1% and 92.3%, respectively in KMG group, 89.8% and 87.5% respectively in control group. There was no significant difference between KMG group and control group （P 〉 0.05）. The cumulative survival rates of KMG group in 9 months and 1 year were 89.7% and 80.8%, respectively, and those of control group were 73.4% and 57.8% respectively. There were significant differences between KMG group and control group （P 〈 0.05）. Conclusion KMG combined with lipiodol in embolization therapy of HCC can enhance the effect of vascular thrombosis, and increase survival. KMG can be used as a new option of TACE.