肝癌介入治疗现状与进展

本文就肝癌介入治疗的方法、相关基础研究及仍然存在的问题对近几年的文献进行了复习。各种介入治疗方法(TACE、热灌注化疗、热栓塞、中药栓塞剂、经皮注射无水乙醇、射频消融、经皮微波凝固、氩氦刀冷冻)均存在不足,双重化疗栓塞术,TACE联合消融,TACE联合基因治疗等综合治疗手段的应用使疗效进一步提高;TACE后肝癌残存灶生物学行为影响方面的研究仅开始涉及,诸多问题尚待解决。以p53抑癌基因治疗、溶瘤病毒治疗为代表的基因治疗、抗血管生成等新的治疗方法的出现,使肝癌的介入治疗进入了新阶段;术中及围手术期处理关系着肝癌介入疗效及并发症防治,有待进一步规范。

The present status and progress of interventional therapy of hepatocellular carcinoma

The article of interventional therapy of hepatocellular carcinoma were reviewed including the method,basic research and the questions remained to be solved.All interventional therapies consisted of transcatheter arterial chemoembolism,transcatheter arterial heat infusion,transcatheter arterial heat embolism,Chinese medicinal herb,percutaneous ethanol injection,radiofrequencey ablation,percutaneous microwave coagulation and cryosurgery had their insufficiencies.The combined therapy,such as double chemoembolism,TACE combined with ablation,TACE combined with gene therapy could further promote the therapeutic effect.The research of the biological behavior of the residue after TACE was just at the beginning with problems still to be acknowledged.With the emerging of anti-oncogene therapy(P 53)and oncolytic virus therapy represented the gene therapy,together with anti-angiogenesis therapy,now the interventional therapy for hepatocellular carcinoma steps in a new stage.The treatment of during and perioperative periods possesses a great correlative influence with the therapeutic effect and complications and should be further standardized.