经导管肝动脉栓塞治疗肝癌的远期疗效观察

262例原发性肝癌行经导管肝动脉注射碘油抗癌药混悬剂栓塞化疗（LP－TAE）后随访4～5年，生存3年以上52例，其中27例生存4年以上，8例生存5年以上，3、4、5年累计生存率分别为21．04％，11．64％和4．03％（寿命表法）。与同期生存3年以内的210例对照比较，结果表明病程分期、肝功能、肿瘤大小与生长方式、肿瘤供血丰富程度、是否伴有门脉癌柱与A－V分流、是否加用明胶海绵栓塞、Lp－TAE后碘油沉积范围、治疗后肿瘤缩小程度、AFP是否降为正常、是否伴发肝内外转移是影响肝癌Lp－TAE远期疗效的重要因素。     

经导管动脉内栓塞术与手术治疗外伤性肝破裂疗效对比分析

目的 探讨经导管动脉内栓塞术(TAE)与手术方法治疗外伤性肝破裂的临床疗效.方法 选择外伤所致肝破裂患者60例,随机分为TAE治疗组与手术治疗组,统计和分析两组患者手术时间、住院时间、恢复饮食时间、术后一周肝内血肿变化、术后一周丙氨酸氨基转换酶(ALT)变化、并发症及不良反应发生率.结果 TAE较传统手术组患者相比,患者手术时间、住院时间、恢复饮食时间、术后一周肝内血肿变化、术后一周ALT变化、并发症及不良反应发生率均低于手术组(P＜0.05).结论 急诊TAE救治创伤性肝破裂出血具有手术时间短,恢复快,对肝功能影响小,并发症及不良反应发生率低,疗效优于传统手术疗法,值得临床应用推广.     

还原型谷光苷酞对肝癌介入治疗造成肝功能损害的预防作用研究

目的探讨对肝癌病人进行介入治疗的同时给予还原型谷光苷酞能否预防由于介入造成的肝功能的进一步损害.方法选择经CT明确诊断为肝癌并且已为中晚期而不适宜进行手术治疗的病人为研究对象,在对其进行肝动脉化疗加肝动脉栓塞(TAE)治疗的同时给予还原型谷光苷酞,即在肝动脉化疗及TAE前先经导管向肝动脉注入1.8g的还原型谷光苷酞,从术后第二天开始连续五天静脉内给予GSH1.8g.通过生化测验观察介入治疗同时给予还原型谷光苷酞病人肝功能生化改变.结果还原型谷光苷酞对介入治疗的肝癌病人的肝功能有明显的保护作用,病人介入后血清谷丙转氨酶(SGPT)、总胆红素(TB)、直接胆红素(DB)较治疗前无明显改变或只有轻度升高.结论还原型谷光苷酞可以预防介入治疗导致的肝癌病人的肝功能进一步损害,减少合并症,同时又不会影响疗效.     

急诊肝动脉栓塞联合二期肝部分切除治疗原发性肝癌破裂出血疗效Meta分析

目的 探讨急诊肝动脉栓塞（transcatheter arterial embolization, TAE）联合二期肝部分切除与急诊肝部分切除治疗原发性肝癌（hepatocellular carcinoma, HCC）破裂出血的疗效区别。方法 通过计算机及手工搜索国内外关于急诊TAE联合二期肝部分切除与急诊肝部分切除治疗HCC破裂出血效果对比的文献,按照纳入标准选择文献,提取相关数据,应用RevMan5.3软件进行统计学分析。结果 共纳入文献5篇,与急诊肝部分切除组相比,急诊TAE联合二期肝部分切除组患者并发症发生率明显降低（OR=0.27, 95%CI：0.03~0.40, P=0.008）,1、2、3年生存率无明显升高（1年生存率：OR=1.63, 95%CI：0.84~3.16, P=0.15;2年生存率：OR=1.40, 95%CI：0.63~3.11, P=0.41;3年生存率：OR=1.13, 95%CI：0.48~2.68, P=0.78）。结论 急诊TAE联合二期肝部分切除治疗HCC破裂出血,与急诊肝部分切除相比,可显著降低围手术期并发症,1、2、3年生存率组间比较差异无统计学意义,在手术后短期内使患者受益更大。     

Hepatocellular carcinoma with a solitary adrenal metastasis and poor hepatic functional reserve: Report of a case

A 54-year-old man with a 15-year history of liver disease, was found by his family physician to have multiple tumors in the right lobe of the liver and a large right retroperitoneal tumor. He was referred and admitted to our institute where a preoperative diagnosis of liver cirrhosis complicated by hepatocellular carcinoma and probable right adrenal metastasis was made. Because his hepatic functional reserve was so poor, only resection of the right adrenal tumor with a splenectomy for hypersplenism and a cholecystectomy for the prevention of cholecystitis secondary to the scheduled transcatheter arterial embolization was performed. The patient was discharged in good clinical condition 5 weeks after surgery.     

Xeroderma pigmentosum variant: complementary molecular approaches to detect a 13 base pair deletion in the DNA polymerase eta gene

Deficiencies of DNA polymerase eta—an enzyme mediating replication past UV-induced DNA damage—predispose individuals to xeroderma pigmentosum variant (XPV) and result in a high incidence of skin cancers. We designed, developed and assessed several complementary molecular approaches to detect a genetically inherited deletion within DNA polymerase eta. RNA was reverse transcribed from XPV fibroblasts and from normal human cells, and standard polymerase chain reaction (PCR) was conducted on the cDNA targeting a region with a 13 base pair deletion within the polymerase eta gene. PCR products were subjected to restriction fragment length polymorphism (RFLP) analysis and cycle DNA sequencing. The deletion was found to eliminate a BsrGI restriction site and affected the number of resultant fragments visualized after gel electrophoresis. Cycle sequencing of polymerase eta-specific amplicons from XPV and normal cells provided a second approach for detecting the mutation. Additionally, the use of a fluorescent nucleic acid dye—EvaGreen—in real-time PCR and melt curve analysis distinguished normal and XPV patient-derived amplicons as well as heteroduplexes that represent heterozygotic carriers without the need for high resolution melt analysis-compatible software. Our approaches are easily adaptable by diagnostic laboratories that screen for or verify genetically inherited disorders and identify carriers of a defective gene.