摘要
在我国,超过80%的肝细胞癌(简称肝癌,HCC)都伴有肝硬化,手术可切除率仅为20%左右。对于有肝硬化基础的小肝癌,最佳治疗手段则是肝移植,因为肝移植不仅治愈了肝癌,同时还治愈了肝硬化。我国肝癌肝移植占肝移植总数近一半,在欧美国家的比例也有升高趋势,其疗效也不断提高。本文主要介绍近年来在肝癌肝移植适应证、移植前的肿瘤治疗、个体化免疫抑制方案、肝癌复发的影响因素以及复发的治疗等方面的进展。
出处
《肝胆外科杂志》
2013年第4期241-244,共4页
Journal of Hepatobiliary Surgery
参考文献17
-
1Bhangui P, Vibert E, Majno P, et al. Intention-to-treat analysis of liver transplantation for hepatocellular carcinoma: living versus de?ceased donor transplantation. Heputology ,2011 ,53 (5) : 1570 - 9.
-
2陈规划,易述红.肝癌肝移植术前的肿瘤降期治疗[J].肝胆外科杂志,2011,19(5):324-326. 被引量:3
-
3Otto G, Schuchmann M, Hoppe-Lotichius M, et al. How to decide a?bout liver transplantation in patients with hepatocellular carcinoma: Size and number of lesions or response to TACE? J Hepatol, 2013 ,59 (2) :279 -84.
-
4Hodriguez-Peralvarez M, Tsochatzis E, Naveas MC, et al. Reduced Exposure to Calcineurin Inhibitors Early Mter Liver Transplantation Prevents Recurrence of Hepatocellular Carcinoma. J Hepatol, 2013.
-
5Menon KV, Hakeem AR, Heaton ND. Meta-analysis: recurrence and survival following the use of sirolimus in liver transplantation for hepa?tocellular carcinoma. Aliment Pharmacol Ther, 2013 ,37 (4) :411 - 9.
-
6安玉玲,张婷婷,蔡常洁.西罗莫司用于治疗肝癌肝移植术后肿瘤复发患者的疗效分析[J].器官移植,2011,2(2):73-76. 被引量:15
-
7Schnitzbauer AA, Zuelke C, Graeb C, et al. A prospective random?ised, open-labeled, trial comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing liver transplantation for hepatocellular carcinoma. BMC Cancer ,2010,10: 190.
-
8Kornberg A, Kupper B, Tannapfel A, et al. Patients with non-] 18 F J fludeoxyglucose-avid advanced hepatocellular carcinoma on clinical staging may achieve long-term recurrence-free survival after liver transplantation. Liver Transpl, 2012,18(1) :53 -6J.
-
9Li MR, Chen GH, Cai CJ, et al. High hepatitis B virus DNA level in serum before liver transplantation increases the risk of hepatocellular carcinoma recurrence. Digestion, 2011 ,84 (2) : 134 - 41.
-
10Siegel AB, Lim EA, Wang S, et al. Diabetes, body mass index, and outcomes in hepatocellular carcinoma patients undergoing liver transplantation. Transplantation, 2012 ,94 ( 5) : 539 - 43.
二级参考文献14
-
1Xin Zhang, Xin-Rong Yang, Xiao-Wu Huang, Wei-Min Wang, Ruo-Yu Shi, Yang Xu, Zheng Wang, Shuang-Jian Qiu, Jia Fan ,Jian Zhou Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory for Organ Transplantation, Shanghai 200032, China,Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China.Sorafenib in treatment of patients with advanced hepatocellular carcinoma:a systematic review[J].Hepatobiliary & Pancreatic Diseases International,2012,11(5):458-466. 被引量:29
-
2郑克立,王长希,陈立中,唐孝达,范昱,闵志廉,齐隽,黎磊石,刘志红,季曙明.雷帕霉素联合环孢素和皮质类固醇预防肾移植急性排斥反应的临床研究[J].中华器官移植杂志,2004,25(4):240-242. 被引量:10
-
3Jian Zhou Jia Fan Zheng Wang Zhi-Quan Wu Shuang-Jian Qiu Xiao-Wu Huang Yao Yu Jian Sun Yong-Sheng Xiao Yi-Feng He Yu-Qi Wang Zhao-You Tang.Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular carcinoma:Report of an initial experience[J].World Journal of Gastroenterology,2006,12(19):3114-3118. 被引量:20
-
4汤钊猷.开展肝癌转移复发研究的意义与途径[J].中华普通外科杂志,2006,21(11):761-761. 被引量:34
-
5Yao FY, Kerlan RK Jr, Hirose R, et al. Excellent outcome following downstaging of hepatocellular carcinoma prior to liver transplantation : an intention-to-treat analysis. Hepatology, 2008,48 : 819 - 827.
-
6Millonig G, Graziadei IW, Freund MC, et al. Response to preopera- tive chemoembolization correlates with outcome after liver transplanta- tion in patients with hepatocellular carcinoma. Liver Transpl, 2007, 13: 272-279.
-
7Lu DS, Yu NC, Raman SS, et al. Radiofrequency ablation of hepato- cellular carcinoma: treatment success as defined by histologic exami- nation of the explanted liver. Radiology ,2005,234:954 -60.
-
8Graziadei IW, Sandmueller H, Waldenberger P, et al. Chemoemboliza- tion followed by liver transplantation for hepatoeellular carcinoma im- pedes tumor progression while on the waiting list and leads to excel- lent outcome. Liver Transpl 2003 ; 9 : 557 - 563.
-
9Llovet JM, Real MI, Mon tana X, Barcelona Liver Cancer Group. Art erial embolisation or ehemoembeli sation versus symptomatic treatment in patients with unreseetable hepatoeellular carcinoma: a ran domised controlled trial. Lancet ;2002, 359 ; 1734 - 1739.
-
10Lewandowski,RJ, Kulik LM, Riaz A, et al. A Comparative Analysis of Transarterial Downstaging for Hepatoeellular Carcinoma: Chemoem- bolization Versus Radioembolization. Am J Transplant, 2009, 9 : 1920 - 1928.
共引文献23
-
1罗超元.定期经门静脉化疗与经肝动脉栓塞化疗预防肝癌切除术后复发的比较研究[J].中国中医药咨讯,2011,3(18):22-23. 被引量:1
-
2郑于剑,霍枫,汪邵平,李鹏.肝癌肝移植免疫抑制剂应用[J].肝胆外科杂志,2011,19(5):329-331. 被引量:1
-
3陈建斌,陈国勇,孙建军,李彩丽.他克莫司和雷帕霉素对肝癌肝移植术后患者的疗效比较[J].中国医疗前沿,2011,6(20):57-58. 被引量:4
-
4钱建平,李湘竑,朱碧丽,周杰.肝癌肝移植术后肿瘤复发的防治策略[J].器官移植,2012,3(5):295-300. 被引量:1
-
5牛斌,易述红,许赤,易慧敏,张琪,孟炜,李华,杨扬,陈规划.肝移植术后新发消化系统恶性肿瘤四例临床分析并文献复习[J].中华肝脏外科手术学电子杂志,2013,2(3):27-30. 被引量:7
-
6于兰,吴谧,王浩,李翠娟.西罗莫司应用的新进展[J].实用中西医结合临床,2014,14(3):90-92. 被引量:6
-
7王寿华,李华,张志刚,吴小材,汪国营,陈规划.Hippo信号通路相关蛋白对肝癌肝移植术后肿瘤复发的影响[J].中华消化外科杂志,2014,13(5):345-351. 被引量:3
-
8李势辉,汪根树.肝癌肝移植术后复发靶向预防和治疗的新希望:索拉非尼[J].器官移植,2014,5(3):145-148. 被引量:3
-
9戴敏,周杰,崔忠林,黄坤.肝移植前行肝动脉介入栓塞化疗的远期效果分析[J].南方医科大学学报,2014,34(8):1145-1148. 被引量:4
-
10黄群爱,胡昆鹏,刘波,姚志成,熊志勇.siRNA沉默ENAH基因对肝癌细胞生长的抑制作用[J].中华肝脏外科手术学电子杂志,2015,4(4):246-249.
同被引文献21
-
1朱志军,高伟,孟醒初,张雅敏,蒋文涛,张建军,张玮晔,沈中阳.脂肪沉着供肝在肝脏移植中的应用[J].中华肝胆外科杂志,2005,11(9):627-629. 被引量:7
-
2McCormack L1, Dutkowski P, E1-Badry AM, et al. Liver transplantation using fatty livers : always feasible? [ J ]. Hepatol, 2011, 54(5) : 1055-1062.
-
3Chui AK, Haghighi K, Painter D, et al. Donaor fatty (steatotic)liver allografts in orthotopie liver transplantation [ J ]. Transplant Proc, 1998, 30(7): 3286-3287.
-
4Chavin KD, Taber DJ, Norcross M, et al. Safe use of highly steatotic livers by utilizingadonor/recipient clinical algorithm [ J 1. Clin Transplant, 2013, 27(5): 732-741.
-
5DeAlwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears [ J ]. J Hepatol, 2008, 48 ( 1 ) : 104-112.
-
6Petrowsky H, McCormack L, Trujillo M, et al. A prospective, randomized, controlled trial comparing intermittent portal triad clamping versus isehemic preconditioning with continuous clamping for major liver resection [ J~. Ann Surg, 2006, 244 (6) : 921- 928.
-
7Angele MK, Rentsch M, Hartl WH, et al. Effect of graft steatosis on liver function and organ survival after liver transplantation [ J 1. Am J Surg, 2008, 195(2) : 214-220.
-
8Marsman WA, Wiesner RH, Rodriguez L, et al. Use of fatty donor liver is associated with diminished early patient and graft survival[J1. Transplantation, 1996, 62(9) : 1246-1251.
-
9Verran D, Kusyk T, Painter D, et al. Clinical experience gained from the use of 120 steatotic donor livers for orthotopie liver transplantation[J~. Liver Transpl, 2003, 9(5) : 500-505.
-
10Spitzer AL, Lao OB, Dick AA, et al. The biopsied donor liver, incorporating macrosteatosis into high-risk donor assessment [ J ]. Liver Transpl, 2010, 16(7) : 874-884.
-
1蔡卫华,吴建军,胡进勇,王卫兵.原发性肝癌肝移植6例临床分析[J].中国现代医学杂志,2006,16(20):3185-3187.
-
2曹晓伟,傅志仁,王正昕,李先兴,郭闻渊,王志才.原发性肝癌肝移植36例临床分析[J].实用癌症杂志,2004,19(1):59-61. 被引量:2
-
3鞠卫强,何晓顺,巫林伟,邰强,胡安斌,王东平,马毅,王国栋,朱晓峰,黄洁夫.以西罗莫司为主的免疫抑制方案在肝癌肝移植受者中的应用[J].中华器官移植杂志,2008,29(12):712-714. 被引量:2
-
4相华,张辉,荣景,韩国林,孟伟,王琰.肾移植术后并发恶性肿瘤10例[J].中华器官移植杂志,2007,28(10):616-616. 被引量:3
-
5王沫,胡建敏,何辉,李世超,刘永光,赵明,郭颖.西罗莫司治疗肾移植后淋巴结Kaposi肉瘤一例[J].中华器官移植杂志,2014,35(5):315-316. 被引量:1
-
6苗芸,于立新.器官移植后恶性肿瘤的发生[J].器官移植,2010,1(1):55-57. 被引量:6
-
7赵虎,韩志坚,徐东亮,殷长军,顾民,张炜.肾移植术后移植肾发生恶性淋巴瘤一例[J].中华器官移植杂志,2006,27(6):381-381.
-
8王槐志,董家鸿,王曙光,别平,何宇,卢倩.肝移植治疗原发性肝癌[J].实用临床医药杂志,2003,7(1):27-30. 被引量:11
-
9安玉玲,张婷婷,蔡常洁.西罗莫司用于治疗肝癌肝移植术后肿瘤复发患者的疗效分析[J].器官移植,2011,2(2):73-76. 被引量:15
-
10郑树森,徐骁,李建辉,高峰,陈峻,舒哲悦,方维佳,卫强.中国肝癌肝移植临床实践指南(2014版)[J].实用器官移植电子杂志,2015,3(2):66-71. 被引量:5