摘要
目的 探讨99m锝 MAA(99mTechnetium macroaggregatedalbumin ,99mTc MAA)肝动脉造影在经肝动脉灌注32 磷 玻璃微球 (32 P GMS)治疗手术不能切除的肝细胞癌 (HCC)中的价值。方法 对 2 8例手术证实不能切除的HCC经皮下埋藏药盒行99mTc MAA肝动脉造影 ,测定肺肝分流比 (Lu/Li)和癌 /肝放射比 (T/N) ,并对其中 18例行经肝动脉灌注32 P GMS选择性内放射治疗 (SIRT)。结果 本组99mTc MAA肝动脉造影测定Lu/Li为 7%± 7% (1%~ 2 5 % ) ,T/N为 5± 3(1~ 14) ;接受SIRT治疗的 18例Lu/Li为 4%± 2 % (1%~ 8% ) ,T/N为 4± 2 (1~ 8) ,其中 15例T/N大于或等于 2 ,3例小于 2。无治疗死亡及严重并发症 ,有效率 6 1% (11/ 18) ,中位生存期 5 5个月 ,术后 3、6、9、12个月生存率分别为 94%、47%、34%和 2 7% ;其中T/N大于或等于 2者中位生存期优于T/N小于 2者 ,分别为 6 6个月和 4 1个月 (P =0 0 11) ,Child′sA级中位生存期优于B级者 ,分别为 9 9个月和 3 8个月 (P =0 0 0 4)。结论 99mTc MAA肝动脉造影是选择性内放射治疗HCC的一项重要措施 ,有助于选择合适病例、提高疗效和避免严重并发症的发生。
Objective[WT5”BZ] To investigate the roles of hepatic arterial scintigraphy with 99m Tc-MAA( 99m Technetium-macroaggregated albumin) in selective internal radiotherapy(SIRT) for the treatment of unresectable hepatocellular carcinoma(HCC) using 32 P-glass microspheres( 32 P-GMS).[WT5”HZ]Methods[WT5”BZ] Hepatic arterial scintigraphy with 99m Tc-MAA was undertaken to measure ratios of lung/liver shunt(Lu/Li) and tumor/non-tumor part of the liver(T/N) in 28 laparotomy-proved unresectable HCCs, and then hepatic arterial infusion of 32 P-GMS was used in 18 cases.[WT5”HZ]Results[WT5”BZ] Lu/Li ratio varied from 1% to 25%(7%±7%),and T/N ratio between 1 and 14 (5±3) in 28 HCCs.Of 18 cases undergoing SIRT, Lu/Li was from 1% to 8% (4%±2%), and T/N was 1 5 to 8 (4±2). There was no treatment-related mortality and major complications, and response rate was 61%(11/18). The median survival time following SIRT was 5 5 months, and 3-, 6-, 9-,12- month survival rates were 94%,47%,34% and 27%, respectively. The median survival time in patients with T/N≥2 was significantly longer compared with those of T/N<2(6 6 months vs 4 1 months, P =0 011), and it was markedly longer in patients of Child′s A than those of Child′s B (9 9 months vs 3 8 months, P =0.004).[WT5”HZ]Conclusion[WT5”BZ] Hepatic arterial scintigraphy with 99m Tc-MAA helps in selecting 32 P-GMS therapy candidate of HCCs. [WT5”HZ]
出处
《中华普通外科杂志》
CSCD
2000年第9期533-535,共3页
Chinese Journal of General Surgery