内镜联合肝动脉栓塞化疗、射频消融治疗肝细胞癌合并胆管癌栓

目的探讨内镜联合肝动脉栓塞化疗（transcatheter arterial chemoembolization，TACE）、射频消融（percutaneous radiofrequency ablation，PRAF）治疗肝细胞癌（hepatocellular carcinoma，HCC）合并胆管癌栓的治疗效果。方法回顾总结1999年1月～2005年12月收治的65例肝细胞癌合并胆管癌栓的诊疗情况。结果65例中，均行内镜胆道引流术或EST及取栓，联合TACE，PRAF治疗。本组无手术死亡。癌栓清除率为95．4％（62／65），肿瘤坏死率为96．9％（63／65），1年生存率为60．0％（39／65），3年生存率为38．5％（25／65）。结论内镜联合TACE及PRAF治疗肝细胞癌合并胆管癌栓不失为一种行之有效的微创治疗方法，疗效优于单纯的内镜、TACE及PRAF治疗。

The treatment effect of endoscopy associated with TACE and percutaneous radiofrequency ablation on hepatocellular carcinoma combinated with bile duct cancer bolt

Objective To investigate the curative effect of endoscopy associated with TACE and percutaneous radiofrequency ablation(PRAF) on hepatocellular carcinoma(HCC) combinated with bile duct cancer bolt.Methods The diagnosis and treatment of hepatocellular carcinoma combinated with bile duct cancer bolt in 65 patients from January 1999 to December 2005 were reviewed and analysed.Results All patients underwent endoscopic biliary passage drainages,EST and bolt-taken,associated with TACE and radiofrequency melt treatment.There was no patient died of the operation.The cancer bolt clear-off rate was 95.4%(62/65),and the tumour necrosing rate was 96.9%(63/65).One year survival rate was 60.0%(39/65),the three-years survival rate was 38.5%(25/65).Conclusion The endoscopy associated with TACE and percutaneous radiofrequency ablation is an effective minimal-traumatic method for the treatment of hepatocellular carcinoma combinated with bile duct cancer bolt.The curative effect is superior to endoscopy,TACE or PRAF treatment when they are used solely.