微波消融结合门静脉灌注对原发性肝癌门静脉癌栓的预防初探

目的探讨超声引导经皮微波消融结合门静脉灌注化疗对肝癌门静脉癌栓的预防作用。方法 78例未形成门静脉癌栓的原发性肝癌患者,采用微波消融结合门静脉灌注化疗治疗;治疗后定期对所有患者进行肝癌血清学指标癌胚抗原(AFP)检测,超声或CT检查肿瘤新生结节及门静脉癌栓形成情况,并随访患者复发率及生存率。结果 78例患者0.5a,1 a,2 a,3 a复发率分别为5%,12%,21%,36%,生存率分别为97%,95%,76%,40%。3 a间患者均无一例门静脉癌栓发生。结论超声引导经皮微波消融联合门静脉灌注化疗治疗肝癌疗效明显并可延长患者生存期,对门静脉癌栓的形成有明显的预防作用。

Preventive value of microwave ablation and portal vein perfusion chemotherapy on hepatocellular carcinoma with portal vein tumor thrombus

Objective It is to investigate the preventive value of percutaneous microwave ablation and portal vein perfusion chemotherapy on hepatocellular carcinoma(HCC) with portal vein tumor thrombus(PVTT) under ultrasound guidance.Methods 78 cases of hepatocellular carcinoma without PVTT in the portal vein were treated with microwave ablation and portal vein perfusion chemotherapy.At regular intervals,the fetoprotein(AFP) were detected,and the new tumor nodules and portal vein tumor thrombus were examined by ultrasound or CT.The recurrence rate and survival rate of all the cases were followed up.Results The recurrence rate of 0.5-,1-,2-,3-year was 5%,12%,21%,40%,and the survival rate was 97%,95%,76%,40% respectively.There was no PVTT in the moment of three years.Conclusion Percutaneous microwave ablation and portal vein perfusion chemotherapy under ultrasound guidance can improve the curative effect and increase survival rate,so it can prevent portal vein tumor thrombus significantly.