肝癌介入治疗模式的探讨

目的探讨肝癌介入治疗的合理模式。方法回顾性总结1000例以不同方式进行介入治疗的肝癌病例资料,通过分析其病理、生化、影像及生存率等临床因素,比较各种治疗方式的价值及优缺点结果经导管节段性肝动脉栓塞化疗(S-TOCE)与常规肝动脉注射碘油抗癌药混悬剂栓塞化疗(C-TOCE)比较,前者对肿瘤的杀伤作用大,对非癌肝组织的损害较C-TOCE轻,生存率优于C-TOCE;经皮无水酒精注射术(PEI)联合栓塞治疗可起到杀死残余癌灶的作用,对非癌肝组织未造成明显损害,生存率较单纯栓塞明显提高。对肝癌的各种并发症采取不同方式的介入治疗,能不同程度地改善患者生存质量或提高生存率。结论肝癌的介入治疗应根据肿瘤大小和类型选择/不同的介入治疗方式;对肝癌的各种并发症采取积极的介入治疗是有效和必要的。

Protocol of Interventional Treatment for Hepatocellular Carcinoma

Objective: To establish a reasonable protocol for intervcntional treatment of hepatotellular carcinoma (HCC). Methods: The data of 1000 HCC patients treated by different kinds of interventional treatments were reviewed with their results of biochemistry, imaging, pathology and survival rate evaluated. The values as well as the pros and cons of these various kinds of interventional treatments were compared in order to find an optimal protocol. Results: Segmental-transcatheter oil chemoembolization (S-TOCE) could more effectively eradicate the tumor yet inflicting less damage on the noncancerous hepatic tissue and giving much higher survival rate than the conventional transcatheter oil chemoembolization (C-TOCE). Precutaneous ethanol injection (PEI) in combination with chemoembolization could eliminate the residual tumor and significantly increase the survival rate without damaging the noncancerous hepatic tissue. The living quality or survival rate could be improved by choosing different ways of interventional treatments to cut down the complications. Conclusion: The selection of different interventional treatments should be done according to the size and type of HCC. Active management is indicated for different complications presenting along with HCC.