肝癌切除术后残肝断面125Ⅰ粒子植入预防肝癌复发

目的 观察肝癌患者肝切除术后残肝断面125Ⅰ粒子植入对肝癌肝内复发的影响.方法 对2003年1月至2007年1月经手术完整切除的肝细胞癌患者85例分为2组.125Ⅰ粒子植入组(43例):肿瘤完整切除后在残肝断面均匀植入125Ⅰ粒子.对照组(42例).所有患者分别于术前1 d和术后7 d、30 d采血,测定转氨酶、胆红素、NK细胞、T细胞亚群、血清中MMP-9及AFP水平.全部患者术后均定期随访复发情况.结果 所有患者术后均顺利恢复,无围手术死亡,无严重并发症.术后两组患者CD3+、CIM+、CD8+和NK细胞及转氨酶、胆红素等指标比较,差异无统计学意义(P＞0.05);125Ⅰ粒子植入组患者AFP、MMP-9明显低于对照组(P＜0.05).125Ⅰ粒子植入组术后0.5年、1年复发率为2.3%、6.9%,与对照组(14.2%、26.1%)相比,差异有统计学意义(P＜0.05).结论 肝癌切除后切125Ⅰ粒子植入能有效地降低AFP、MMP-9水平.术后局部复发率显著下降.

125Ⅰ prevents local cancer recurrence after hepatectomy

Objective To investigate the therapeutic effectiveness of residue liver embedding of iodine-125 on recurrence after hepatectomy in hepatocellular carcinoma patients. Methods In this study, 85 cases with resectable hepatocellular carcinoma were collected and divided into two groups randomly: intrahepatic embedding of iodine-125 group and control group. The serum values of T lymphocyte phenotypes (CD3 + CD4 + ,CD8 +), NK cells,TB IL, ALT, AST, AFP and MMP-9 were measured in all patients 1 day before and 7, 30 days after the operation respectively; B ultrasonic and CT were used to detect for intrahepatic dissemination and recurrence of HCC after hepateetomy. All patients were followed-up from 16 to 55 months (average 35.4 months). Results Surgery were successful in all cases. There were no difference in T lymphocyte phenotypes, NK cells, TBIL, ALT and AST between the two groups (P＞0.05). The serum values of AFP and MMP-9 were much lower in the intrahepatic embedding of iodine-125 group than the control group(P<0.05). In iodine-125 embedding group, the 0.5-, 1-year recurrent rates were 2.3%、6.9%, respectively, compared with 14.2% and 26.1%, respectively, in control group (all P<0.05). Conclusions Intrahepatic embedding of iodine-125 in HCC patients after hepatectomy decreases values of AFP, MMP-9 and local cancer recurrence rate in HCC patients after hepatectomy.