肝细胞癌源性肾上腺转移瘤经导管动脉化疗栓塞治疗时供血动脉情况分析

摘要

目的：探讨肝细胞癌源性肾上腺转移瘤经导管动脉化疗栓塞（TACE）治疗时供血动脉的情况，为临床工作提供参考。方法回顾性选取2005年1月—2015年8月就诊于新疆医科大学附属肿瘤医院符合纳入与排除标准的肝细胞癌源性肾上腺转移瘤患者11例为研究对象，所有患者行 TACE 治疗。按照供血动脉支数将患者分为 A 组（1支，4例）和 B 组（≥2支，7例）。收集患者一般资料，包括性别、年龄、乙型肝炎、肝硬化、肝内病灶、肝外病灶（除肾上腺）情况，统计瘤体供血动脉支数、来源血管、瘤体最大径，记录患者 TACE 治疗次数。结果两组患者性别、年龄、乙型肝炎发生率、肝硬化发生率、肝内病灶发生率、肝外病灶发生率比较，差异无统计学意义（ P ＞0.05）。11例患者共有19支瘤体供血动脉，其中1支4例（36.4％），2支6例（54.5％），3支1例（9.1％）。来源血管：肾上腺下动脉8支（42.1％），肾上腺上动脉5支（26.3％），肾上腺中动脉3支（15.8％），肝动脉2支（10.5％），胃十二指肠动脉1支（5.3％）。两组患者瘤体最大径构成情况比较，差异无统计学意义（ P =0.242）。B组患者 TACE 治疗次数大于 A 组（t =-2.292，P =0.048）。结论肝细胞癌源性肾上腺转移瘤的供血动脉来源丰富，供血动脉支数越多，需要进行的 TACE 治疗次数越多。%Objective To investigate the status of feeding arteries during transcatheter arterial chemoembolization (TACE ) therapy for adrenal metastases from hepatocellular carcinoma, in order to provide references for clinical practice. Methods A retrospective analysis was made on the data of 11 patients with adrenal metastases from hepatocellular carcinoma who accorded with inclusion and exclusion criteria and received treatment in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2005 to August 2015. All the patients were administrated with TACE therapy. According to the number of feeding arteries,the patients were divided into group A(1 vessel,4 patients )and group B( ≥2 vessels,7 patients). General data were collected,including gender,age,hepatitis B,cirrhosis,intrahepatic nidi,extrahepatic nidi (except adrenal gland);the number of tumor feeding arteries,source vessels and the maximum diameter of tumor were calculated;the times of TACE therapy undertaken by the patients were recorded. Results The two groups were not significantly different in gender,age and the incidence rates of hepatitis B,cirrhosis,intrahepatic nidi and extrahepatic nidi(P > 0. 05). There were a total of 19 feeding arteries in the 11 patients. There was 1 tumor feeding artery in 4 cases(36. 4% ),2 feeding arteries in 6 cases(54. 5% ),3 feeding arteries in 1 case(9. 1% ). In the aspect of source of feeding artery,there were 8 (42. 1% )inferior suprarenal arteries,5 (26. 3% )superior suprarenal arteries,3 (15. 8% )middle suprarenal artery,2 (10. 5% )hepatic arteries,and 1 gastroduodenal artery(5. 3% ). The two groups were not significantly different in the optimum tumor diameter of composition situation(P = 0. 242). The TACE times of group B were significantly more than those of group A (t = - 2. 292,P = 0. 048). Conclusion The sources of feeding artery to adrenal metastases from hepatocellular carcinoma are various. The higher number of feeding arteries is,the more times of transcatheter arterial chemoembolization therapy is needed.