结肠癌肝转移的血管造影及其化疗栓塞疗效观察

目的：探讨大肠癌肝转移的肝动脉造影表现及其肝动脉化疗栓塞的疗效。方法：回顾性分析80例大肠癌肝转移患者的肝动脉造影图像，根据其造影表现分为多血供和少血供两组。分别评价肝动脉化疗栓塞的总体和各组的疗效。结果：80例患者中多血供者35例（43．8％），肝动脉血管造影表现为肝动脉增粗，肿瘤血管和染色丰富。少血供者45例（56．2％），表现为肝动脉纤细，少量或无肿瘤血管，肿瘤染色不明显。80例患者总体CR＋PR为52．5％（42／80），多血供组CR＋PR为85．7％（30／35），少血供组PR＋CR为26．7％（12／45），两组比较差异有统计学意义（P＜0．01）。80例患者总体6、12和24个月的生存率分别为86．4％、53．6％、28．8％。多血供组分别为94．3％、71．4％、45．7％，少血供组分别为80％，37．85％、15．6％。结论：肝动脉化疗栓塞是治疗大肠癌肝转移的一种有效方法。转移肿瘤血供丰富程度是决定疗效的关键。

Angiographic Appearance and Effect of Transcatheter Arterial Chemoembilization for Liver Metastasis of Colon Carcinoma

Objective: To discuss the hepatic arteriographic appearances of the liver metastases of the colon carcinoma, and the effect of transcatheter arterial chemoembolization (TACE) in the treatment of those metastatic tumors. Methods: Hepatic arteriographic images of 80 patients with liver metastases of the colon carcinoma were analyzed retrospectively, and two groups were divided as hypervascular and hypovascular tumors according to the tumor vascular. The effect of total the two groups of TACE was evaluated respectively. Results: 35 patients (43.8%) were included in the hypervascular group with enlarged hepatic artery and abundant tunor vascular and tumor stain, 45 patients (56. 2%) were included in the hypovascular group with little or no tumor vascular and tumor stain. PR + CR of 80 patients was 52.5% (42/80). PR + CR of the hypervascular group was 85.7% (30/35), and 26.7% (12/45) in the hypovascular group. The difference between two groups was statistically significant (P<0.01). The over-all 6- , 12- , and 24-month survival rate was 86.4%, 53.6%, 28.8% respectively. The survival rate of the hypervascular group was 94. 3% , 71. 4% , 45. 7% respectively, while for hypovascular group was 80% , 37.85% , 15.6% , respectively. Conclusion: TACE is an effective therapy for the treatment of liver metastases from colon carcinoma . The abundant degree of the tumor vascular is the important factor to determine the effect of TACE in the treatment of patients with liver metastases from colon carcinoma.