原发性肝癌DSA表现与TACE疗效的关系分析

目的:探讨原发性肝癌数字减影血管造影(DSA)表现与经肝动脉化疗栓塞(TACE)疗效的关系。方法:选择2012年4月—2014年4月间行DSA造影并进行TACE治疗的原发性肝癌患者61例,根据术中DSA表现,将患者分为富血供组(44例)和中等血供组(17例),术后随访3个月至2年,以m RECIST标准评估肿瘤疗效,分析DSA血供分型与患者疗效及预后的关系。结果:TACE术后2个月,富血供组完全缓解(CR)2例(4.5%),部分缓解(PR)29例(65.9%),疾病稳定(SD)6例(13.6%),疾病进展(PD)7例(8.6%),客观有效率(CR+PR)70.4%,疾病控制率(CR+PR+SD)84.0%;中等血供组CR 0例(0.0%),PR 5例(29.4%),SD 4例(23.5%),PD 8例(47.1%),客观有效率29.4%,疾病控制率52.9%。富血供组、中等血供组中位生存期分别为14与7.9个月,6、12、24个月累计生存率分别为91.0%、68.0%、20.4%与59.1%、23.0%、12.1%,差异均有统计学意义(均P0.05)。结论:原发性肝癌DSA血供分型与TACE治疗效果密切相关,富血供型肝癌TACE治疗效果较好。

Analysis of relationship between DSA findings and efficacy of TACE therapy in primary liver cancer

Objective: To investigate the relationship between digital subtraction angiography (DSA) findings and efficacy of transcatheter arterial chemoembolization (TACE) therapy in primary liver cancer. Methods: Sixty-one patients with primary liver cancer undergoing DSA examination and TACE therapy from April 2012 to April 2014 were selected. According to the intraoperative DSA findings, the patients were divided into rich blood supply group (44 cases) and moderate blood supply group (17cases). Postoperative followed-up was conducted for 3 months to 2 years, the therapeutic response was assessed by mRECIST criteria, and the relations of DSA blood supply group of the tumor with the response and prognosis of the patients were analyzed. Results: Two months after TACE, in rich blood supply group, complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) was found in 2 cases (4.5%), 29 cases (65.9%), 6 cases (13.6%) and 7 cases (8.6%), and the objective response rate (CR+PR) was 70.4%, and disease control rate (CR+PR+SD) was 84.0%, respectively; in moderate blood supply group, CR, PR, SD and PD was 0 case (0.0%), 5 cases (29.4%), 4 cases (23.5%) and 8 cases (47.1%), and the objective response rate and disease control rate was 29.4% and 52.9%, respectively. For rich blood supply group and moderate blood supply group, the median survival time was 14 and 7.9 months, and the accumulated 6-, 12- and 24-month survival rate was 91.0%, 68.2% and 20.4%, and 59.1%, 23.0% and 12.1%, respectively, and the differences had statistical significance (all P<0.05). Conclusion: For primary liver cancer, the DSA blood supply classification is closely related to the efficacy of conventional TACE therapy, and cases with rich blood supply may have a better response to TACE treatment.