干旱区生态环境知识资源中心(Arid): 介入治疗后38例中晚期肝癌患者生存5年以上的因素分析

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	介入治疗后38例中晚期肝癌患者生存5年以上的因素分析
其他题名	Clinical analysis of 38 cases of unresectable primary hepatic carcinoma survived for more than 5 years after interventional therapy
	周泽健; 罗鹏飞; 邵培坚; 陈晓明; 张良明; 李伟科; 李勇; 许荣德; 庄文行; 张华
来源期刊	中华放射学杂志
ISSN	1005-1201
出版年	2002
卷号	36 期号:9 页码:792-796
中文摘要	目的探讨中晚期肝癌介入治疗远期疗效的影响因素。方法从1988年5月至1996年4月，对660例肝癌行动脉碘油药物乳剂栓塞化疗（LP－TACE），其中63例尚行经皮无水乙醇消融治疗（PEI）。660例中，96例获病理确诊。临床分期为临床Ⅱ期543例，Ⅲ期117例；肿瘤分型为单结节型171例，多结节型67例，巨块型388例，弥漫型34例；肿瘤瘤径≤10cm者256例，＞10cm者404例；动脉造影为富血型538例，乏血型122例；甲胎蛋白（AFP）＜20mug/L者473例，＞20mug/L者187例；肝功能A组430例、B级164例、C级66例。60例共行LP－TACE 1765次（平均2．7次），其中63例共行PEI 165次（平均2．6次）。介入治疗后生存年以上者38例，其中8例获得病理证实。660例均进行随访，失访者按失访日期作为死亡时间统计。着重就生存年以上38例的情况行回顾性分析。结果 38例肝癌生存5年以上，其中生存超过7年14例，超过10年6例（2例至今分别已生存了13年6个月、13年3个月）；5、7、10年的生存率分别为5．8％（38／660）、2．1％（14／660）、0．9％（6／660）。38例中，临床分期均为Ⅱ期；肿瘤分型为单结节型20例，多结节型8例，巨块型10例，弥漫型0例；肿瘤瘤径≤10cm者27例，＞10cm者11例；动脉造影均为富血型；AFP＜20mug/L者18例，＞20mug/L者20例；肝功能A级29例，B级9例，C级0例。38例共行LP－TACE 175次（平均4．6次），其中18例共行PEI 75次（平均4．2次）。结论临床分期、肿瘤分型、肿瘤大小、造影情况、AFP变化和肝功能是影响中晚期肝癌远期疗效的重要因素，而LP－TACE质量的保证（包括完全栓塞法和侧支栓塞法）、PEI的应用、并发症的处理和长期随访是提高远期疗效的重要环节。
英文摘要	Objective To investigate the affecting factors on long-term effect of interventional therapy for unresectable primary hepalic carcinoma (PHC). Methods From May 1988 to April 1996, 660 cases of unresectable PHC were treated with lipiodol transcatheter hepatic artery chemoembolization (LP-TACE), 63 cases of them also received percutaneous ethanol injection (PEI). Of the 660 cases, 96 cases were proved by pathology. The clinical stage included stage II (543 cases) and stage III (117 cases). The tumor pattern included mononodular type (171 cases), multinodular type (67 cases), large lesion type (388 cases), and diffuse type (34 cases). The angiographic findings included hypervascular type (538 cases) and hypovascular type (122 cases). 473 cases had AFP < 20mug/L and 187 cases had AFP > 20mug/L. According to the liver function (Child’s system), 430 cases belonged to grade A, 164 cases grade B, and 66 cases grade C. 660 cases underwent LP-TACE for 1765 times (mean 2.7 times) and 63 cases received PEI for 165 times (mean 2.6 times). Of the 38 cases survived more man 5 years after interventional therapy, 8 cases were demonstrated by pathology. All the 660 cases were followed up for more than 5 years and 38 cases were analyzed retrospectively and concentratively. Results 38 cases of unresectable PHC survived more than 5 years after interventional therapy. Among them, 14 cases survived for more than 7 years and 6 cases survived for more than 10 years. The survival rate of 5, 7, and 10 years was 5. 8% (38/660), 2.1% (14/660), and 0.9% (6/660), respectively. 2 cases had survived for more than 13 years up to now. All the 38 cases were in clinical stage E, and the tumor, pattern included mononodular type (20 cases), multinodular type (8 cases), large lesion type (10 oases), and diffuse type (0 cases). All these 38 cases were hypervascular type angiographically . AFP < 20mug/L was found in 18 cases, and > 20mug/L in 20 cases. The liver function included grade A in 29cases, grade B in 9 cases, and grade C in 0 cases. 38 cases underwent LP-TACE for 175 times (mean 4.6 tines) and 18 cases received PEI for 75 times (mean 4.2 times). Condusion Clinical stage, tumor pattern, tumor size, blood supply of tumor, portal vein tumor thrombi, A-V shunt, change of AFP, and liver function are the important factors affecting the long-term survival rate of interventional therapy for unresectable PHC i while quality control of LP-TACE (both complete embolization and collateral embolization), combination of PEI, treatment of complications, and long-term follow-up are the important procedures to increase the long-term effect.
中文关键词	介入治疗 ; 中晚期肝癌 ; 肝肿瘤
英文关键词	liver neoplasms embolization, therapeutic lodized oil alcohol ethyl evaluation studies
语种	中文
国家	中国
收录类别	CSCD
WOS类目	ONCOLOGY
WOS研究方向	Oncology
CSCD记录号	CSCD:1092250
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/203727
作者单位	广东省人民医院肿瘤科, 广州, 广东 510080, 中国
推荐引用方式 GB/T 7714	周泽健,罗鹏飞,邵培坚,等. 介入治疗后38例中晚期肝癌患者生存5年以上的因素分析[J],2002,36(9):792-796.
APA	周泽健.,罗鹏飞.,邵培坚.,陈晓明.,张良明.,...&张华.(2002).介入治疗后38例中晚期肝癌患者生存5年以上的因素分析.中华放射学杂志,36(9),792-796.
MLA	周泽健,et al."介入治疗后38例中晚期肝癌患者生存5年以上的因素分析".中华放射学杂志 36.9(2002):792-796.