载药微球介入栓塞治疗在肝癌肝移植术前降期治疗中的应用

The value of deb-tace as down-stage therapy for hepatocellular carcinoma before liver transplantation

目的探讨载药微球介入栓塞在肝癌肝移植术前降期治疗的价值。方法回顾性分析2016年1月至2018年1月天津市第一中心医院因超过米兰标准肝癌接受载药微球栓塞的30例患者,随访降期的效果,分析病理结果及随访患者的无瘤生存情况。结果载药微球介入栓塞的技术成功率100%,降期至符合UCSF标准76.7%(23/30),降期至符合米兰标准53.3%(16/30)。13例患者降期成功并接受肝脏移植,病理结果显示完全坏死率为30.8%(4/13),肿瘤坏死率>50%者占92.3%(12/13)。无严重并发症发生。肝移植术后肿瘤复发率为7.7%(1/13)。结论载药微球介入栓塞治疗在肝癌肝移植降期治疗中具有安全高效的作用。

Objective To evaluate the drug-eluting-beads (DEB)-TACE as down-stage therapy for hepatocellular carcinoma before liver transplantation.Methods Inclusion criteria: the hepatocellular carcinoma exceeding the standard of Milan criteria.From Jan 2016 to Jan 2018,30 patients received DEB-TACE as down-stage therapy for hepatocellular carcinoma before liver transplantation.4 weeks after DEB-TACE, the imaging examination was performed.The patients who received the liver transplantation, the pathological conditions were recorded and the tumor free survival of the patients was followed up.Results 30 patients received 30 times DEB-TACE successfully.76.7%(23/30 ) patients was down-staged to meet UCSF criteria ,53.3%(16/30) patients was down-staged to meet Milan criteria.13 patients had being given liver transplantation, pathology showed that DEB-TACE achieved complete necrosis in 30.8%(4/13) cases.No significant treatment related complications were observed.After liver transplantation 12 patients are alive with no tumor recurrence.The tumor recurrence rate after liver transplantation was 7.7%.Conclusion DEB-TACE is safe and effective as down-stage therapy for hepatocellular carcinoma before liver transplantation.