TACE联合经皮经肝门静脉穿刺PEI治疗HCC合并PVTT的临床研究

Study of the clinical efficacy and safety of TACE combined with PET for the treatment of HCC

目的探讨肝动脉化疗栓塞(TACE)联合经皮经肝门静脉穿刺无水酒精注射(PEI)治疗原发性肝癌(HCC)合并门静脉癌栓(PVTT)的临床疗效及安全性。方法2007年6月-2010年10月对30例不能手术治疗的HCC合并PVTT患者行TACE联合经皮经肝门静脉穿刺PEI治疗。结果 1个疗程治疗后行CT检查示:PVTT消失或缩小5例,占16.7%,癌栓未增大17例,占56.7%;25例AFP值升高患者中19例AFP值下降,占76%;随访0.5、1、2年生存率分别为86.7%(26/30)、53.3%(16/30)、10.0%(3/30),全部病例未出现出血、气胸、胆漏、肝功能衰竭、针道种植转移等严重并发症。结论 TACE联合经皮经肝门静脉穿刺PEI治疗HCC合并PVTT是一种安全、有效的治疗方法,并发症少。

Objective To investigate the clinical efficacy and safety of hepatic arterial chemoembolization （TACE） combined with the percutaneous hepatic portal vein puncture percutaneous ethanol injection （PEI） for the treatment of the hepatocellular car- cinoma（HCC） complicating with portal vein tumor thrombus（PVTT）. Methods During the period from June 2007 to October 2010, 30 HCC complicating with PVTF patients, the tumor of whom could not＇t be resected, were given TACE combined with percuta- neous transhepatic portal vein puncture PEI treatment. We evaluated the change of PVTT size and AFP value after treatment, also the patients＇ survival time. Results After a course of treatment, 5 patients＇ （16.7%） PVTT disappeared or shrunk, 17 patients＇（56. 7%） PVTT didn＇t increase. There were 25 patients with an elevated AFP value before treatment, 19 of which（76%） decreased after the treatment. The overall 0.5, 1, 2-year survival rates were 86.7%, 53.3% and 10.0%. All cases didn＇t appear hemorrhage, pneumothorax, bile leakage, liver failure, the needle tract implantation metastasis and other serious complications. Conclusion TACE combined with percutaneous hepatic portal vein puncture PEI was a safe and efficient treatment, with few complications, for HCC complicating with PVTT.