原发性肝癌腹壁转移的介入治疗

目的探讨对原发性肝癌腹壁转移灶采用介入治疗的方法和疗效。方法对8例原发性肝癌腹壁转移患者行动脉插管灌注化疗、栓塞治疗,或经皮穿刺瘤内无水乙醇注射术。结果7例患者行动脉插管化疗栓塞术获得技术成功,术后5例患者腹壁转移灶内碘油沉积良好；2例患者部分瘤灶内碘油沉积不满意,行分次瘤体内无水乙醇注射术；1例患者动脉插管未能找到供血动脉,单纯采用经皮穿刺瘤体内无水乙醇注射。所有患者瘤灶处腹壁疼痛缓解或消失,3例腹壁体表肿块隆起者,肿块变小,变软。7例AFP升高患者,术后有不同程度下降。1例隆起肿块发生破溃、感染,其他患者未发生严重并发症。结论对原发性肝癌腹壁转移灶采用动脉插管灌注化疗、栓塞治疗,结合经皮穿刺瘤体内无水乙醇注射,对控制肿瘤生长、缓解疼痛,提高生存质量是可行方法之一。

Interventional therapy for abdominal wall metastasis of primary liver carcinoma

Objective To evaluate the interventional approach and efficiency in treating abdominal wall metastasis of primary liver carcinoma.Methods Eight patients suffering from abdominal wall metastasis of primary liver carcinoma were treated by transcatheter arterial chemoembolization(TACE)or/and percutaneous intratumoral ethanol injection(PEI).Results TACE was successfully performed in 7 patients with good lipiodol deposition within the lesions in five cases,but with partial depositions in two cases of rather poor result,and followed by splitting PEI.In 1 patient no feeding artery could be found during the arteriography therefore only PEI was undertaken.Pain caused by abdominal wall metastasis was alleviated or eliminated in all patients with tumor shrinkage and softened in 3 patients with bulgy lesions.AFP levels decreased in 7 patients after the therapy.One case developed abdominal wall ulceration and infection.No other severe complication occurred.Conclusion Patients with abdominal wall metastasis of primary liver carcinoma, TACE combined with PEI is a practical way to control tumor growth,relieve pain,and improve living quality of patients.