经动脉栓塞术治疗肝细胞腺瘤的系统评价

目的  评估经动脉栓塞术（transarterial embolization，TAE）在出血和非出血肝细胞腺瘤（hepatocellular adenoma，HCA）中的作用。方法  检索EMBASE、PubMed、Web of Science数据库中已发表的采用TAE治疗HCA的相关研究，检索时限为2000年1月至2017年12月。按照纳入和排除标准筛选文献、提取资料和质量评估后进行系统评价。结果  共21篇文献符合标准纳入研究，包括1 481例HCA患者，其中接受TAE治疗患者148例。接受TAE治疗的148例患者中出血性HCA 93例，非出血性HCA 55例，其中非急性TAE治疗45例。共110个肿瘤符合修订的RECIST标准，其中瘤体完全消失和部分缩小所占的比例分别为10.0％(11/110)和71.8％(79/110)。72例患者可避免肝切除手术，其中出血性HCA 23例，非出血HCA 49例；45例非急性TAE治疗的患者中，43例不需进一步手术治疗。住院期间均无死亡或严重毒副反应发生。结论  TAE是HCA患者安全的治疗方法，对于非出血性HCA患者TAE或可作为肝切除术的合理替代治疗方法。

Systematic review of transarterial embolization for hepatocellular adenoma

Objective To evaluate the role of transarterial embolization（TAE） in bleeding and non-bleeding hepatocellular adenoma（HCA）. Methods Relevant studies for the transarterial embolization in HCA from the databases EMBASE，PubMed and Web of Science were searched from January 2000 to December 2017. Literature screening，data extraction and quality assessment were conducted according to inclusion and exclusion criteria. Results A total of 21 studies were eligible for inclusion in the study，including 1，481 patients with HCA，of whom 148 were treated with TAE. Of the 148 patients who underwent TAE, 93 had HCA bleeding and 55 had non-bleeding HCA，of which 45 were non-acute TAE. A total of 110 tumors met the revised RECIST criteria，with the proportion of complete and partially reduced tumors being 10.0% （11/110)）and 71.8%（79/110）, respectively. A total of 72 patients could avoid hepatectomy，including 23 cases of bleeding HCA and 49 cases of non-bleeding HCA. Of the 45 patients who were treated with non-acute TAE，43 did not require further surgery. No mortality or serious adverse side effects occurred during hospitalization. Conclusions TAE may be considered as a safe treatment for patients with HCA. For patients with non-bleeding HCA，TAE may be a reasonable alternative treatment besides hepatectomy.