葡聚糖微球肝栓塞治疗肝癌疗效的病理学评估

Pathological assessment of the therapeutic effect on hepatomas treated with Dextran Microsphere hepatic artery emboliztion

病理组织学评估葡聚糖微球肝栓塞治疗肝癌的疗效。 11例原发性肝癌行葡聚糖微球肝栓塞治疗 ,栓塞后择期作肝切除术。切除后的肝瘤标本作组织病理研究以观察肿瘤的坏死程度及葡聚糖微球在人体内的状况。7例肝癌病灶为完全坏死 ,未见存活癌细胞 ;另 4例为不完全坏死。两者相比 ,完全坏死组肿瘤较为远离膈面、肝裂、及胆囊窝等动脉侧支吻合丰富的区域。葡聚糖微球能产生均一的末梢性动脉栓塞。微球在体内 191天仍未被吸收。门脉系统内未见栓子微球。部分远离肝侧支循环的肝癌可通过葡聚糖微球肝栓塞得到临床治愈。

To evaluate the therapeutic effect and the mechanism of dextran hepatic artery embolization for hepatoma.Partial hepatectomy was performed in 11 patients with hepatoma pretreated by dextran hepatic artery embolization.All specimens were done for histopathologic studies in order to observe the destiny of dextran microspheres and necrotic degree of the tumor.Complete necrosis of the tumor was found in 7 cases of the patients and incomplete necrosis of the tumor in other 4.The tumors in incompletely necrotic group were nearer to areas in which the arterial collateral anastomoses are very rich.The necrotic degreee was related neither to the existence and thickness of tumor capsule nor to the tumor capsule invasions.Dextran microspheres could lead permanent distal arterial embolization.The microspheres were very biocompatible and of little foreign body reaction.No inflammatory changes seen inside and outside the embolized artery 191 days after embolization,dextran microspheres was not resorbed and the vessel recanalization was also not seen.Dextran microspheres were not found in portal vein system.So the hepatomas remote from collateral circulation could be cured with dextran hepatic artery embolization alone.