Objective:This study aimed to introduce and evaluate a new embolization technique for the right gastric artery(RGA) during percutaneous implantation of a port-catheter system for hepatic arterial infusion chemotherapy...Objective:This study aimed to introduce and evaluate a new embolization technique for the right gastric artery(RGA) during percutaneous implantation of a port-catheter system for hepatic arterial infusion chemotherapy(HAIC).Methods:From January 2013 to January 2017,159 patients with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system.In 86 of these patients(56 men;aged 28-88 years;mean:60.6±12.0 years),in whom the RGA was obvious on arteriography,embolization of RGA was attempted using microcoils to protect the gastric mucosa during HAIC.In the first phase(first three years),antegrade embolization of the RGA using a 2.7 Fr microcatheter was performed in 55 patients.In the second phase(next two years),embolization of the RGA was attempted by combining antegrade embolization and retrograde embolization through the left gastric artery(LGA) in 31 patients.The success rates and the incidence of acute gastroduodenal mucosal toxicity(AGMT) in these two groups were compared.Results:The total success rate of the RGA embolization was 70.9%.The success rate was 83.9% in 31 patients who underwent combined antegrade and retrograde embolization,which was significantly higher than that of antegrade embolization alone(63.6%) performed in 55 patients(p=0.047).No complications related to embolization of RGA were documented.The incidence of AGMT was 29.1%(16/55) in patients in the first phase,which was significantly higher than that in the patients in the second phase(9.7%,3/31)(p=0.037).Conclusion: A combination of retrograde embolization via LGA could increase the success rates of RGA embolization and reduce the incidence of AGMT after HAIC.展开更多
目的：研究术前区域动脉灌注化疗对进展期胃癌患者血清学指标及肿瘤组织中凋亡基因表达的影响。方法：将2012年4月~2014年5月期间我院收治的80例进展期胃癌患者纳入研究,随机分为两组,观察组患者术前接受区域动脉灌注化疗,对照组患者术...目的：研究术前区域动脉灌注化疗对进展期胃癌患者血清学指标及肿瘤组织中凋亡基因表达的影响。方法：将2012年4月~2014年5月期间我院收治的80例进展期胃癌患者纳入研究,随机分为两组,观察组患者术前接受区域动脉灌注化疗,对照组患者术前不接受区域动脉灌注化疗,检测两组患者血清学指标及肿瘤组织中凋亡基因的表达。结果：（1）促凋亡分子：观察组患者胃癌组织中脾酪氨酸激酶（Syk）、Fas、FasL的mRNA含量和蛋白含量均高于对照组（P〈0.05）;（2）抗凋亡分子：观察组患者胃癌组织中Fas相关死亡域样白介素1-β转换酶抑制蛋白（FLICE-inhibitory protein,FLIP）、蛋白磷酸酶2A的癌性抑制因子（cancerous inhibitor of protein phosphatase 2A,CAP2A）、Survivin的mRNA含量和蛋白含量均低于对照组（P〈0.05）;（3）血清肿瘤标志物：观察组患者血清中DDK1、EXOSC2、YY1、sMICA、CD44v含量均低于对照组（P〈0.05）。结论：术前区域动脉灌注化疗能够诱导肿瘤细胞凋亡,降低血清肿瘤标志物含量,是治疗进展期胃癌的理想方法。展开更多
基金supported by National Natural Science Foundation of China (no. 81471759)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (code: ZYLX202117)。
文摘Objective:This study aimed to introduce and evaluate a new embolization technique for the right gastric artery(RGA) during percutaneous implantation of a port-catheter system for hepatic arterial infusion chemotherapy(HAIC).Methods:From January 2013 to January 2017,159 patients with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system.In 86 of these patients(56 men;aged 28-88 years;mean:60.6±12.0 years),in whom the RGA was obvious on arteriography,embolization of RGA was attempted using microcoils to protect the gastric mucosa during HAIC.In the first phase(first three years),antegrade embolization of the RGA using a 2.7 Fr microcatheter was performed in 55 patients.In the second phase(next two years),embolization of the RGA was attempted by combining antegrade embolization and retrograde embolization through the left gastric artery(LGA) in 31 patients.The success rates and the incidence of acute gastroduodenal mucosal toxicity(AGMT) in these two groups were compared.Results:The total success rate of the RGA embolization was 70.9%.The success rate was 83.9% in 31 patients who underwent combined antegrade and retrograde embolization,which was significantly higher than that of antegrade embolization alone(63.6%) performed in 55 patients(p=0.047).No complications related to embolization of RGA were documented.The incidence of AGMT was 29.1%(16/55) in patients in the first phase,which was significantly higher than that in the patients in the second phase(9.7%,3/31)(p=0.037).Conclusion: A combination of retrograde embolization via LGA could increase the success rates of RGA embolization and reduce the incidence of AGMT after HAIC.
文摘目的：研究术前区域动脉灌注化疗对进展期胃癌患者血清学指标及肿瘤组织中凋亡基因表达的影响。方法：将2012年4月~2014年5月期间我院收治的80例进展期胃癌患者纳入研究,随机分为两组,观察组患者术前接受区域动脉灌注化疗,对照组患者术前不接受区域动脉灌注化疗,检测两组患者血清学指标及肿瘤组织中凋亡基因的表达。结果：（1）促凋亡分子：观察组患者胃癌组织中脾酪氨酸激酶（Syk）、Fas、FasL的mRNA含量和蛋白含量均高于对照组（P〈0.05）;（2）抗凋亡分子：观察组患者胃癌组织中Fas相关死亡域样白介素1-β转换酶抑制蛋白（FLICE-inhibitory protein,FLIP）、蛋白磷酸酶2A的癌性抑制因子（cancerous inhibitor of protein phosphatase 2A,CAP2A）、Survivin的mRNA含量和蛋白含量均低于对照组（P〈0.05）;（3）血清肿瘤标志物：观察组患者血清中DDK1、EXOSC2、YY1、sMICA、CD44v含量均低于对照组（P〈0.05）。结论：术前区域动脉灌注化疗能够诱导肿瘤细胞凋亡,降低血清肿瘤标志物含量,是治疗进展期胃癌的理想方法。
