超选择性肝动脉化学治疗栓塞治疗13例尾状叶肝癌的疗效评价

摘要

目的 评价超选择性肝动脉化疗栓塞(TACE)治疗尾状叶肝癌的疗效.方法 回顾性分析2013年3月至2016年12月收治的13例孤立性尾状叶肝癌患者,用2.6F的微导管行超选择性肝动脉化学治疗栓塞治疗,栓塞材料为超液化碘化油.术后评估肿瘤供血动脉数量、超选技术成功率以及近期疗效和远期生存状态.13例患者的计量资料用均数±标准差((-x)±s)表示.结果 肿瘤单支动脉供血者61.5％ (8/13),多支动脉供血者38.5％(5/13),超选技术成功率为84.6％(11/13);行超选择性肝动脉化学治疗栓塞患者术后1个月完全缓解率63.6％ (7/11);截尾随访期内,行超选择性肝动脉化学治疗栓塞的11例患者生存10例,未成功行超选择性肝动脉化学治疗栓塞的2例患者生存1例.结论 超选择性TACE治疗尾状叶肝癌的可行性及安全性值得肯定,且具有良好的疗效,对尾状叶肝癌的预后有重要临床意义.%Objective To investigate the clinical effect of ultraselective transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) originating from the caudate lobe.Methods A retrospective analysis was performed for 13 patients with solitary HCC originating from the caudate lobe who were admitted to Department of Interventional Radiology in PLA General Hospital from March 2013 to December 2016.A 2.6-F microcatheter was used to perform ultraselective TACE,and the embolization material was ultra-liquefied iodinated oil.The number of tumor-feeding arteries,success rate and short-term efficacy of ultraselective technique,and long-term survival were evaluated after surgery.Results Of all patients,8 (61.5％) had a single tumor-feeding artery and 5 (38.5％) had multiple tumor-feeding arteries.The success rate of ultraselective technique was 84.6％ (11/13).The complete remission rate at 1 month after ultraselective TACE was 63.6％ (7/11).During the follow-up period after the expiration date,10 out of 11 patients who underwent successful ultraselective TACE survived,and one out of two patients who underwent failed ultraselective TACE survived.Conclusion Ultraselective TACE has good feasibility,clinical effect,and safety in the treatment of HCC originating from the caudate lobe,with an important clinical significance in the prognosis of such disease.