常规与节段性栓塞化疗在小肝癌治疗中的比较研究(附56例报告)

目的　探讨常规栓塞化疗 (TOCE)与节段性栓塞化疗 (S TOCE)在小肝癌治疗中的疗效比较。方法　 5 6例中2 6例行TOCE治疗 42次 ,平均 1.6次 /例 ,3 0例行S TOCE治疗 3 9次 ,平均 1.3次 /例。术后随访 6～ 3 6个月以上 ,并行B超、螺旋CT(SCT)及DSA (再次治疗时 )检查 ,以判断疗效。结果　 2 6例行TOCE治疗病例 ,碘油完全充填 12例 ,占46.2 % ,-年内复发 5例 ,占 19.2 % ;3 0例行S TOCE治疗病人 ,碘油完全充填 2 5例 ,占 83 .3 % ,一年内复发 2例占 6.7% ;TOCE与S TOCE在小肝癌治疗中完全充填及术后复发等比较有显著差异 (P <0 .0 1)。结论　S TOCE是小肝癌非手术治疗首选方法。在疗效上与TOCE比较有显著差异     

TOCE联合HIFU治疗原发性肝癌的DSA检查及意义

目的：评价TOCE联合HIFU治疗原发性肝癌的DSA表现及意义。方法：50例原发性肝癌患者接受TOCE联合HIFU治疗,比较治疗前后的DSA表现。随机选出同期50例单纯TOCE治疗的患者进行对照研究。结果：研究组与对照组治疗后肿瘤血管减少、消失、不变及增多分别为76％（38／50）8％（4、50）;16％（8／50）、0;60％（30／50）、4％（2、50）;30％（15／50）、6％（3／50）（P＜0．05）。病灶体积缩小分别为76％（38／50）和58％（29／50）（P＜0．05）。新病灶形成分别为4例和6例,侧支开放为2例和3例。结论：TOCE联合HIFU是治疗中晚期原发性肝癌的一种有效的治疗方法,DSA可以准确判断治疗后肿瘤大小;血供情况,早期发现复发及转移灶,在判断疗效及决定是否再治疗中具有重要价值。     

不同方案经导管栓塞治疗对肝癌疗效影响的回顾性分析

目的评价经导管不同方案栓塞治疗对肝癌疗效的影响。方法收集我院2010年收治行经导管栓塞治疗的BCLC分期为A期或B期的肝癌患者44例,根据采用经动脉栓塞（TAE）、经动脉碘油化疗栓塞（TOCE）及联合采用TAE、TOCE及经动脉化疗栓塞（TACE）治疗将其分为TAE组、TOCE组及混合组。结果所有44例患者中入选TAE组21例,入选TOCE组15例,入选混合组8例,3组肝癌患者生存期的差异无统计学意义。结论经导管不同方案栓塞治疗对肝癌患者的生存期无明显影响。     

Management of hepatocellular carcinoma in renal transplant recipients

BACKGROUND AND OBJECTIVE: In Hong Kong where hepatitis B virus (HBV) infection is endemic, hepatocellular carcinoma (HCC) accounts for 20% of all malignant transformations in renal transplant recipients. The aim of the present study was to review the management and outcome of HCC in renal transplant recipients at a specialized surgical center. METHOD: A retrospective analysis on the data collected prospectively in a tertiary referral center. RESULTS: From January 1991 to December 2002, five renal transplant recipients were diagnosed to have primary HCC and received treatment in our center. There were four men and one woman with a median age of 47 (range, 38-68) years. Four of them had cadaveric renal transplantation whereas one had live donor transplantation. All of them were HBV carriers. The median tumor size was 3.5 cm (range, 1.8-8 cm). All tumors, except one, were diagnosed in sub-clinical stage by surveillance serum alpha-fetoprotein assay and percutaneous ultrasonography. Four patients were treated with surgical resection and one received transarterial oily chemoembolization (TOCE) as their primary treatments. There was one peri-operative death and the remaining three surgically treated patients were alive 4, 62, and 64 months after the resection. One patient developed recurrence 18 months after curative resection and was treated with TOCE. The patient with unresectable disease was alive for 50 months after the initial diagnosis. The surgical resection and overall survival rates of these patients were better than the published results. CONCLUSION: Early detection with regular serum alpha-fetoprotein assay and ultrasonographic study, vigilant care in the peri-operative period, long-term follow-up for detection and treatment of recurrence, as well as close collaboration between renal physicians and liver surgeons may improve the outcome of treatment of HCC in renal transplant recipients.