Combined transcatheter arterial chemoembolization and percutaneous ethanol injection for the treatment of large hepatocellular carcinoma: local therapeutic effect and long-term survival rate

The aim of our study was to investigate local therapeutic effects and long-term results of combined transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of large hepatocellular carcinoma (HCC). Eight-six patients (67 males and 19 females, age range 48–75 years, mean age 65.1 years) with Child-Pugh class A (n = 48) or B (n = 38) liver cirrhosis and a large HCC (main tumor 3.1–8 cm in diameter with no more than two daughter nodules) were enrolled in a prospective study. All patients underwent a single TACE session followed by PEI. Follow-up ranged from 4 to 65 months (mean 27.8 months, median 26 months). No major complication occurred. The local therapeutic effect, as assessed on the basis of findings at CT and MR imaging, was complete response in 71 of 86 patients (82 %) and partial response in 15 of 86. Overall survival rates by the Kaplan-Meier method were 92 % at 1 year, 83 % at 2 years, 69 % at 3 years, 58 % at 4 years, and 47 % at 5 years. Survival of Child-Pugh A patients (75 % at 3 years and 59 % at 5 years) was significantly longer (p < 0.01) than that of Child-Pugh B patients (61 % at 3 years and 35 % at 5 years). Combined TACE and PEI is an effective treatment for large HCC. Received 10 June 1997; Revision received 28 August 1997; Accepted 2 September 1997     

Transcatheter arterial embolization followed by percutaneous ethanol injection in the treatment of hepatocellular carcinoma

Purpose The aim of this study was to evaluate the effectiveness of transcatheter arterial embolization (TAE) followed by percutaneous ethanol injection (PEI) in the treatment of large hepatocellular carcinoma (HCC) lesions.Methods Fifteen patients with HCC were treated by means of TAE followed by 6–16 ethanol injections. In 10 patients, the HCC was solitary (3–8 cm); 3 patients had 1, and 2 patients had 2 daughter nodules (3 cm or smaller) in addition. In 12 of 15 main tumors and in 4 of 7 daughter nodules, a tumor capsule was observed by computed tomography or magnetic resonance imaging.Results Combined treatment with TAE and PEI resulted in complete necrosis of 12 of 15 main tumors and 7 of 7 daughter nodules on biopsy. Treatment failure (incomplete necrosis) occurred in 3 unencapsulated main tumors. The 1-year survival rate in 10 patients was 100%.Conclusion The combination of TAE and PEI proved to be an effective treatment for large HCC, including those with 1–2 small daughter nodules. The presence of a tumor capsule significantly correlates (p < 0.05) with a favorable outcome of treatment.     

Percutaneous ethanol injection therapy of hepatoma

Percutaneous ethanol injection (PEI) under ultrasound guidance is a new therapeutic possibility for patients with small hepatocellular carcinoma (HCC). In our series, 35 patients with a total of 50 tumors were treated (tumor size 0.8–5.0 cm). No significant complications occurred after 502 sessions of ethanol injection. Thirty patients presented complete remission, as no evidence of residual HCC was revealed during the follow-up (mean 16 months). Five patients with lesions larger than 3.5 cm presented only partial remission. The survival curves at 1, 2, and 3 years (Kaplan Meier method) were 100%, 100%, and 80%, respectively. In comparison with the survival curves of untreated and surgically treated patients. PEI seems to be the better treatment for operable HCC smaller than 3 cm, and for lesions smaller than 5 cm in patients with high surgical risk.     

Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience

The objective of our work was to evaluate the long-term results of percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in patients with liver cirrhosis. A total of 184 cirrhotic patients with HCC underwent PEI as the only anticancer treatment over an 8-year period. Patients were followed after therapy by means of clinical examinations, laboratory tests, and US and CT studies performed at regular time intervals. Survival rates were determined according to the Kaplan-Meier method. The overall survival was 67 % at 3 years, 41 % at 5 years, and 19 % at 7 years. The 3-, 5-, and 7-year survival rates of patients with single HCC ≤ 3 cm (78, 54, and 28 %, respectively) were significantly higher (p < 0.01) than those of patients with single HCC of 3.1–5 cm (61, 32, and 16, respectively) or multiple HCCs (51, 21, and 0 %, respectively). Survival of Child-Pugh A patients (79 % at 3 years, 53 % at 5 years, and 32 % at 7 years) was significantly longer (p < 0.01) than that of Child-Pugh B patients (50 % at 3 years, 28 % at 5 years, and 8 % at 7 years). A selected group of 70 patients with Child-Pugh A cirrhosis and single HCC ≤ 3 cm had a 7-year survival of 42 %. Long-term survival of cirrhotic patients with HCC treated with PEI is comparable to that reported in published series of matched patients submitted to surgical resection. Received 12 March 1996; Revision received 24 June 1996; Accepted 23 August 1996     

乙酸局部注射治疗实验性肝肿瘤

目的 :对比评价 5 0 %乙酸与无水酒精对兔实验性肝肿瘤的治疗作用以及对肝肾功能的影响。方法 :随机将植有VX2肝肿瘤的 3 0只实验兔分为 5 0 %乙酸注射组和无水酒精注射组 ,每组 15只 ,分别于开腹直视下向肿瘤内注入乙酸或无水酒精 ,治疗后 1、3、5和 7d分别采静脉血检测血清ALT、AST、BUN、Cr变化 ,术后 7d处死动物 ,观察肿瘤坏死情况及坏死区范围。结果 :5 0 %乙酸及无水酒精治疗后均导致肿瘤及周围肝组织凝固性坏死 ,两组肿瘤完全坏死率分别为 73 .3 %( 11/15 )和 3 3 .3 %( 5 /15 ) ,局部坏死区平均直径分别为 ( 1.6± 0 .7)cm和 ( 0 .9± 0 .5 )cm ,肿瘤完全坏死率及坏死区范围差异均有显著性意义 (P <0 .0 5 )。治疗后 1周内两组动物ALT、AST均有一过性升高 ;乙酸治疗组术后 1周内BUN和Cr亦有一过性升高 ,酒精治疗组术后BUN和Cr变化不明显。结论 :5 0 %乙酸较无水酒精具有更强的致组织坏死能力 ,同时 5 0 %乙酸可能具有轻度的肾脏毒性作用     

Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy

We treated 35 patients who had hepatic cysts (30 congenital cysts, 5 hydatid cysts) with percutaneous puncture and sclerotherapy. After puncture and drainage of the cyst, a 95% alcohol solution was instilled as sclerosing agent into the cystic cavity. In all the patients, cyst puncture and drainage was successful. Follow-up in all cases was at least 12 months. In three uncooperative patients, cysts recurred due to incomplete sclerosis of the lining epithelium of the cyst wall. No major complications were encountered in all cases. All congenital cysts were treated on an outpatient basis. Patients with hydatid cyst were hospitalized for 48 h after puncture and aspiration. In our opinion, percutaneous drainage and sclerosis of congenital hepatic cysts can be considered an effective alternative to surgical treatment.     

肝癌冷冻消融治疗中CT和MRI引导效果对照研究

目的 探讨CT和MR两种影像技术在肝癌冷冻消融治疗中的价值.方法 121例肝癌患者共131个病灶行氩氦刀治疗,其中男73例、女48例,平均年龄(60±8)岁,61例行CT引导下冷冻消融、60例行MR引导下冷冻消融.CT引导采用大孔径16层扫描仪,带有CT透视功能;MR引导采用0.35 T开放式扫描仪,辅助红外导航仪,应用快速梯度回波和快速自旋回波扫描序列.氩氦刀采用MR兼容冷冻系统,冷冻探针为17 G、外径1.47 mm.根据病灶位置、形态、毗邻结构,采用多针组合,适形冷冻.冷冻消融模式为2次冻-融循环消融法,术中间断扫描监测病灶消融情况.以平均扫描时间、病灶显示及冰球监测、肿瘤消融有效率、并发症、生存时间为评价指标,肿瘤消融有效率的比较采用x2检验.结果 CT引导平均扫描时间为(5.6±1.8)min,MR引导平均扫描时间(22.0±2.6)min.CT在病灶精细程度及肋骨等结构的显示方面优于MR;CT扫描中金属探针可以产生伪影,难于显示碘油栓塞后病灶的冰球形成情况.MR在显示、导引和监测邻近膈肌、肝门、胆囊区等特殊部位病灶方面优于CT;而且MR不受高密度栓塞剂及金属探针的影响,在显示病灶、监测冰球形成和病灶消融情况等方面优于CT.但是,MR扫描时间长,低场强开放式MR图像质量不及CT.两组病例随访12个月,CT引导组和MR引导组1年生存率分别为90.2%(55/61)、90.0%(54/60),术后1个月两组病例肿瘤消融有效率分别为75.4%(46/61)、83.4%(50/60).(x2检验=4.4056,P＜0.05).结论 CT引导快速直接,尤其对穿刺路径中的肋骨等结构显示优于MR.MR具有多平面成像对显示病灶与肿瘤的关系,监测治疗效果方面优于CT,尤其在显示、导引和监测邻近膈肌、肝门、胆囊区等特殊部位病灶的穿刺消融优于CT引导.     

栓塞微球在肝癌介入治疗中的应用

目的 评价栓塞微球对肝癌的栓塞性能,观察经导管栓塞治疗肝癌的近期疗效与不良反应.方法 选择23例(34个病灶)原发性肝癌患者,经股动脉插管至肿瘤供血动脉,沣射半量化疗药物及碘油3～5 ml后将栓塞微球0.5～6 ml混入适量对比剂透视下注入,至血流明显减慢或血管铸型时停止.每隔1个月复查肝脏增强CT或MRI、血清AFP.如病灶仍有强化或新生病灶、AFP继续增高者重复治疗.观察临床疗效与不良反应.结果 全组无CR,PR 9例,NC 13例,PD 1例,有效率(CR PR)为39.1%,获益率(CR PR NC)为95.7%.28/34枚血供丰富、强化明显的病灶中首次治疗后有17枚有残余强化,另11枚病灶完全栓塞.17枚有残余强化的病灶中,10枚病灶重复治疗,其中3枚获完全栓塞.11枚完全栓塞的病灶在2～9个月的随访中,4枚再次出现残余强化,2枚重复治疗后均获完全栓塞.AFP阳性的18例患者中,11例明显降低,6例无明显变化,1例明显升高.术后观察5～14 d,发热18例,肝区疼痛11例,恶心呕吐6例,ALT较术前明显升高2例,BIL明显升高1例,WBC均无变化.结论 栓塞微球经导管注射治疗肝癌,栓塞性能优越,临床疗效确切,不良反应少,是一种优良的肿瘤栓塞剂.     

肝动脉内持续灌注治疗结直肠癌术后肝转移瘤

目的：探讨5－氟尿嘧啶（5－Fu)／甲酰四氢叶酸钙（CF）经肝动脉持续性灌注治疗结直肠癌肝转移的临床疗效。方法：62例无外科手术指征的结直肠癌肝转移患者，其原发病灶均已作根除术，依据肝动脉内化疗方式不同分为2组：A组32例，采取经皮肝动脉内植入药盒，术后经药盒每个月连续5d持续灌注5－Fu／CF及地塞米松；B组30例，采取每个月1次肝动脉插管大剂量灌注5－Fu/CF。结果：A，B组有效率（完全缓解＋部分缓解）分别为50．0％和23．3％（P＜0．05）。A组1年，2年生率分别为65．6%，39．3％，B组分别为36．7％，11．5％（P＜0．05）。A组1年，2年生存率分别为65．6％，39．3％，B组分别为36．7％，11．5％（P＜0．05）。A组生存质量明显改善，肝，胆，胃十二指肠毒性均较B组低。结论：经药盒肝动脉持续性灌注5－Fu/CF并配合地塞米松治疗结直肠癌肝转移可明显改善患者生存质量，提高生存率。     

Radiofrequency Ablation with a New Perfused-Cooled Electrode Using a Single Pump: An Experimental Study in Ex Vivo Bovine Liver

The purpose of this study was to assess the efficacy of a new perfused-cooled electrode that uses a single pump for creating a large ablation zone in explanted bovine liver. This was done by comparing with the radiofrequency (RF) ablation zones that were created with a monopolar cooled electrode to the RF ablation zones that were created by the new perfused-cooled electrode. We developed a new perfused-cooled electrode that uses a single pump by modifying a 17-gauge cooled electrode (Radionics) with a 2.5-cm outer metallic sheath (15-gauge) in order to allow use of the internal cooling water (5.85 % hypertonic saline) for the infused saline. Thirty ablation zones were created in explanted bovine livers (12-min ablation cycle; pulsed technique; 2000 mA, maximum) with three different regimens: group A, RF ablation with the 17-gauge cooled electrode; group B, RF ablation with the 15-gauge cooled electrode; group C, RF ablation with the perfused-cooled electrode. T2-weighted magnetic resonance (MR) imaging was obtained immediately after RF ablation for calculating volumes of the ablation zone. Following MR imaging, the ablation zones were excised and measured for transverse diameters and vertical diameters. The transverse diameter, vertical diameter, and the calculated volumes of the ablation zones on MR imaging were compared among the groups. Ablation zones created with the perfused-cooled electrode (group C) were significantly larger than those created with the 17-gauge cooled electrode (group A) and the 15-gauge cooled electrode (group B) according to the transverse diameter and vertical diameter on the gross specimens (p < 0.05): 3.6 ± 0.38 cm and 4.4 ± 0.20 cm in group A, 3.7 ± 0.08 cm and 4.6 ± 0.16 cm in group B, and 5.4 ± 0.65 cm and 6.0 ± 0.56 cm in group C, respectively. On the MR imaging, the calculated volumes of the ablation zones in group C were significantly larger than those in groups A and B (p < 0.05): 23.1 ± 8.7 cm³ in group A, 28.9 ± 5.7 cm³ in group B, and 80.0 ± 34 cm³ in group C, respectively. A new perfused-cooled electrode using a single pump could efficiently increase the size of the ablation zone in liver compared with a monopolar cooled electrode, and this was due to its simultaneous use of internal cooling and saline infusion.     

1.5 T MR导向下肝脏恶性肿瘤射频消融治疗技术初探

目的 探讨1.5 T MR引导下对肝脏恶性肿瘤射频消融治疗的可行性.方法 23例44个经病理证实、不能或不愿手术的肝脏恶性肿瘤病灶,其中11例为原发性肝癌、12例为肝转移癌,肿瘤最大径平均(3.3±1.8)cm,均采用MR兼容多极射频针在1.5 T MR引导下进行射频消融治疗.术后MR扫描观察消融情况,消融灶完全覆盖原病灶、范围超出病灶边缘0.5～1.0 cm为消融完全.结果 所有消融均顺利完成,平均手术时间(93±33)min,消融灶均完全覆盖病灶,无胆瘘、膈肌穿孔、黄疸、气胸等并发症发生.射频电极针在MR图像上呈低信号.消融灶在T2WI序列上呈低信号,周围可见薄层高信号环绕;T1WI序列上消融灶呈明显高信号,边界清晰;DWI上消融灶呈等低信号,周围呈环状稍高信号.结论 1.5 T MR引导下肝脏恶性肿瘤射频消融是安全、有效的技术.     

Therapeutic ethanol injection of hepatocellular carcinomas undetectable by angiography and lipiodol computed tomography

Seven smaller than 2 cm in diameter hepatocellular carcinomas (HCC) undetectable by hepatic arteriography and computed tomography (CT) after intraarterial injection of iodized oil (Lipiodol CT) were diagnosed by ultrasonography-guided fine-needle biopsy in 6 patients. All lesions were treated by percutaneous ethanol injection (PEI) in 1–3 weekly intervals. No recurrences have been demonstrated after 7–15 months. The treatment of HCCs undetectable by angiography and Lipiodol CT presents a problem as transcatheter arterial embolization is considered ineffective due to, poor vascularity. PEI appears to be an excellent treatment for these small HCCs.     

Combined treatment of radiofrequency ablation and acetic acid injection: an in vivo feasibility study in rabbit liver

The aim of this study was to compare the effects of percutaneous radiofrequency ablation (RFA) combined with percutaneous acetic acid injection (PAI) and either therapy alone for their effects on in vivo rabbit liver tissue. Thirty New Zealand white rabbits were included in this study and were allocated to three groups: group A, conventional RFA (n=10); group B, PAI (n=10); and group C, combined RFA and PAI (n=10). Under US guidance, 1 ml of 50% acetic acid was injected into the target area of the liver parenchyma through a 21-G Chiba needle before performing RFA. The RFA was then performed using a 17-G internally cooled electrode with 1-cm active tip, and RF energy (30 W) was applied for 3 min with or without acetic acid injection. After RFA or PAI, contrast-enhanced CT and CT pathologic correlation were performed. The maximum diameters of the thermal lesions in each group were compared. All procedures were technically successful, and a total of 30 lesions (10 lesions for each group) were produced. The mean maximum diameter of the coagulation necrosis in the rabbits of group C (25±9 mm) was significantly larger than the diameters of the other groups: 12.2±1 mm (group A) and 14.3±3 mm (group B; p=0.001). On contrast-enhanced CT scanning, the lesions of group B (7 of 10, 70%) appeared frequently irregular compared with those of groups A (2 of 10, 20%) and C (4 of 10, 40%; p=0.08). There were seven complications (23.3%): a localized hematoma in a group-A rabbit; two hematomas and one chemical peritonitis in group-B rabbits; and a hematoma, a chemical peritonitis, and a burn injury to the stomach in group-C rabbits. Compared with the group-A rabbits (1 of 10, 10%), the group-B (3 of 10, 30%) and group-C rabbits (3 of 10, 30%) showed a tendency toward complications, but the difference was not significant (p=0.48). Under the present experimental condition, combined RFA and PAI was able to increase the diameter of coagulation necrosis up to 2.5 cm without significantly increasing complications.     

肝脏血管平滑肌脂肪瘤的CT影像表现

目的探讨分析肝脏血管平滑肌脂肪瘤（angiomyolipoma,AML）CT表现及特征。方法回顾性分析8例经手术病理证实,且均进行了CT检查的肝脏AML患者资料。结果8例肝脏AML中脂瘤型1例,以脂肪成分为主,CT显示大片脂肪密度;血管瘤型2例,以血管成分为主,CT增强动脉期明显强化;肌瘤型1例,主要是由平滑肌成分组成,平扫密度均匀,增强呈均一或不均匀强化;混合型4例,三种成分含量相似,增强扫描呈不均匀强化。结论不同病理类型的肝脏AML的CT表现有所不同,CT检查可以清晰的显示出肿瘤的影像特征,了解肝脏AML的病理类型与CT表现之间的关系,有助于提高肝脏AML的cT诊断率。     

Percutaneous treatment of hydatid cysts (Echinococcus Granulosus)

A new method called PAIR (Puncture-Aspiration of cyst contents—Injection of hypertonic saline solution—Reaspiration) was used as a percutaneous treatment of hydatid cysts. In 37 patients, 120 cysts were punctured. All patients had not been considered surgical candidates. The cysts were localized in the liver, peritoneum, spleen, kidneys, muscles, and bones. In 70% of patients, good results were obtained. Recurrence occurred in 5 of 120 cysts, all at the beginning of our experience when a low concentration of sodium chloride solution was injected. Moderate allergic reactions occurred during seven cyst aspirations. No anaphylactic shock, sudden deaths or dissemination of cyst contents were observed.     

Quantitative mr imaging data in the evaluation of hepatic metastases during systemic chemotherapy

To identify changes induced by chemotherapy in hepatic metastases, 34 patients with metastases underwent magnetic resonance (MR) imaging before the start of systemic chemotherapy and monthly thereafter. The number, size, and morphologic patterns of the lesions and changes in quantitative parameters (signal-to-noise ratio [S/N], contrast-to-noise ratio, and signal intensity ratio) were evaluated and correlated with response to treatment and prognosis. After treatment, seven patients showed a partial response, 18 had stable disease, and nine had progressive disease. No relevant changes in the patterns of the lesions were observed. Quantitative data showed that patients with a good prognosis had an increase in S/N on T1-weighted images and a relative decrease on T2-weighted images; patients with a poor prognosis showed a decrease in S/N on T1-weighted images and an increase on T2-weighted images. The differences between patient groups were significant for both T1- and T2- weighted images. This study demonstrates the value of MR imaging in follow-up of liver metastases and suggests the usefulness of quantitative MR imaging data.     

瘤内注射153Sm-树脂微球治疗肝癌的实验研究

目的：观察瘤内注射^153Sm-树脂微球（RTMS）在荷人肝癌小鼠模型体内的药代动力学和治疗作用。方法：建立荷人肝癌小鼠模型，60只为体内分布研究组，每只小鼠瘤内注射^153Sm-RTMS 18．5MBq，连续计算10d内小鼠血液、肿瘤和各脏器组织的每克组织百分注射剂量（％ID／g)。30只为治疗实验组，再分瘤内注射370 MBq ^153Sm-RTMS和0．1mL生理盐水3个亚组，计算20d内肿瘤缩小率，计数外周血细胞，并作肿瘤病理检查。结果：（1）^153Sm-RTMS瘤内注射后30min的滞留率为94．34％，第8天时仍高达62．21％。（2）少量^153Sm可弥散入血，其全身分布以肺脏为最高，肝脏次之。（3）370和555MBq治疗量均有明显疗效，尤以555MBq组更好。（4）治疗量^153Sm-RTMS对小鼠造血功能无明显影响。结论：^153Sm-RTMS标记牢固、稳定性好，瘤内注射后可长时间滞留在肿瘤组织内，全身扩散量很小，大剂量注射的疗效明显。     

Low infusion rate digital subtraction angiography to predict regional perfusion in hepatic arterial chemotherapy

Digital substraction angiography (DSA) with a low injection rate of contrast (0.5 ml/sec) was studied as a means of predicting the regional perfusion of percutaneously placed catheters for hepatic arterial chemotherapy. In 64 hepatic artery catheter placements, conventional injection rate angiography (3–5 ml/sec) and low infusion rate DSA exams were compared to conventional radionuclide perfusion studies performed with Tc-99m-MAA. In 58 of 64 cases (90.6%) the conventional arteriogram correctly predicted the extent of hepatic perfusion, whereas in 63 of 64 cases (98%), the low flow DSA exam correctly predicted hepatic perfusion. The conventional arteriogram correctly predicted the extent of extrahepatic perfusion in 32 cases (50%), with a sensitivity of 100%, but a specificity of only 39.6%. The DSA exam was correct in defining the presence or absence of extrahepatic perfusion in 57 of 64 cases for a sensitivity of 82% and a specificity of 91%. Despite the quantitative difference between the low infusion rate DSA study and the chemotherapy infusion (10 ml/hr), it is a useful tool to assist in the correct positioning of temporary catheters for hepatic arterial chemotherapy.     

Combined Therapy of Radiofrequency Ablation and Ethanol Injection of Rabbit Liver: An <Emphasis Type="Italic">In Vivo</Emphasis> Feasibility Study

Our purpose was to compare the effects of percutaneous radiofrequency ablation (RFA) combined with percutaneous ethanol injection (PEI) on the extent of ablation in in vivo rabbit liver tissue as compared with either therapy alone. Twenty-two New Zealand white rabbits were included in this study and allocated into three groups: group A: conventional RFA (n = 6); group B: PEI (n = 6); group C: combined RFA and PEI (n = 10). For combined RFA and PEI, under ultrasound guidance, 1 mL of absolute ethanol was injected into the target area of the liver parenchyma through a 21-gauge Chiba needle before performing RFA. RFA was performed using a 17- gauge internally cooled electrode with 1-cm active tip, and RF energy (30 W) was applied for 3 minutes, with or without ethanol injection. After RFA or PEI, contrast-enhanced computed tomography and CT-pathologic correlation were performed. The short- axis and long-axis diameters of thermal lesions of each group were compared. All procedures were technically successful and a total of 38 lesions were produced. The mean short-axis and long-axis diameter of the coagulation necrosis in rabbits of group C (combination of RFA and PEI), were significantly larger than those of other groups: group A: 10.3 ± 2 mm and 11.4 ± 2 mm; group B: 3.1 ± 1 mm and 4.3 ± 2 mm; group C: 12.8 ± 3 mm and 17.8 ± 6 mm (p < 0.05). On contrast-enhanced CT scan, the lesions of rabbits of the group C appeared to be more frequently irregular compared to those of group A (20% in group A vs. 67% in group C). There were three complications including two localized hematomas and one cardiopulmonary failure. Combined RFA and PEI could increase the dimension of coagulation necrosis without increasing complications and therefore, may be successfully used for treating larger lesions.     

联合应用沙培林碘化油乳剂及促凝血药物治疗肝脏恶性肿瘤

目的 评价联合应用沙培林碘化油乳剂及促凝血药物治疗肝脏恶性肿瘤的疗效.方法 联合应用沙培林碘化油乳剂及促凝血药物行免疫栓塞治疗50例肝脏恶性肿瘤患者,其中原发性肝癌18例、转移性肝癌32例.对比治疗前后外周血白细胞、CD4 、CD8 淋巴细胞、CD4 /CD8 比值、AFP、CEA水平及影像学指标.结果 免疫栓塞术后患者CD4 淋巴细胞比例明显升高,CD8 淋巴细胞比例基本同术前,外周血白细胞计数升高,CD4 /CD8 比值下降,术前AFP及CEA水平升高而术后下降者分别为86%(13/15)和87%(21/24).发热为最常见的术后不良反应100%(50/50).结论 联合应用沙培林碘化油乳剂及促凝血药物治疗肝脏恶性肿瘤是一种安全有效的方法,对原发性肝癌与转移性肝癌均有较好的疗效,是一种更趋标准化的免疫栓塞方法.