多结节性肝癌的治疗探讨

总结２９２例多结节性肝癌的治疗。全身化疗１１１例，肝动脉栓塞化疗５８例，多次局切６７例，局切后并用肝动脉、门静脉插管化疗５６例。结果：ＡＦＰ转阴率分别为０、３８．１％、７４．５％、８４．６％；各组１、２、３、５年生存率分别为１８．２％、４５．６％、５２．２％、５３．８％；１．９％、３８．９％、２５．８％、５０．９％；０、７．５％、２０．３％、４６．３％；０、１．９％、５．２％、１７．３％。提示，多结节性肝癌手术切除优于药物治疗，切除后并用肝动脉、门静脉插管化疗优于单纯局切，非手术治疗者。碘油抗癌药物乳化液栓塞治疗优于全身化疗（Ｐ均＜０．０５）。

Treatment for Multifocal Primary Hepatocellular Carcinoma

Two hundred and ninty two cases of multifocal primary hepatocellular carcinoma(MPHC) were studied.Of them 111 cases received systemic chemotherapy, 58 cases had transhepatic arterial embolization and chemotherapy (TAEC),67 cases had local resection and followed in another 56 cases by transhepatic artery and portal vein chemotherapy.Resumption of AFP level to normal was seen in 0, 38.1%, 74.5%, 84.6% respectively in the four subgroups. The 1-, 2-, 3-, 5-year survival rates of these subgroups of patients were 18.2%, 45.6%, 52.2%, 53.8%; 1.9%,38.9%,25.8%,50.9%; 0,7.5%,20.3% ,46.3%; 0, 1.9%, 5.2%, 17. 3%,respectively. It is suggested that surgical removal of tumor was more effective than systemic chemotherapy and even more so if it was followed by transvascular(hepatic artery and portal vein) chemotherapy.For unresectable cases, Lipiodol TAE and chemotherapy was more effective than system chemotherapy(P<0. 05).