Antiviral therapy using sofosbuvir combined with ribavirin after transcatheter arterial chemoembolization for hepatitis C virus-related hepatocellular carcinoma with tumor thrombus in the right atrium: a case report
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摘要:
<正>原发性肝癌(以下简称肝癌)是最常见的恶性肿瘤之一,在我国其死亡率在恶性肿瘤中居第2位。HCV慢性感染者发生肝癌的风险是普通人群的15~20倍,HCV慢性持续感染30年后,发生肝癌的概率为1%~3%。肝癌常侵犯肝静脉、门静脉、下腔静脉形成癌栓,而累及右心房形成癌栓者较罕见。现将收治的丙型肝炎相关肝癌合并右心房癌栓,经肝动脉化疗栓塞术(TACE)后给予索磷布韦联合利巴韦林抗病毒治疗患者1
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Key words:
- liver neoplasms /
- hepatitis C /
- chemoembolization, therapeutic /
- antiviral agents /
- case reports
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[1]HU ZL, ZHU LZ, YANG RJ, et al.Manifestations of primary liver cancer complicated by inferior vena cava/right atrium tumor thrombus on digital subtraction angiography and their dinical significance[J].Chin J Clin Res, 2014, 27 (11) :1402-1404. (in Chinese) 胡忠林, 朱林忠, 杨仁杰, 等.原发性肝癌并下腔静脉-右心房癌栓的DSA表现及临床意义[J].中国临床研究, 2014, 27 (11) :1402-1404. [2]LUO ZH, QIN M, ZHANG XX, et al.Transcatheter arterial chemoembolization for hepatocellular carcinoma complicated by tumor thrombus in inferior vena cava and right atrium[J].J Intervent Radiol, 2012, 21 (12) :1035-1038. (in Chinese) 罗中华, 秦勉, 张学昕, 等.原发性肝癌合并下腔静脉及右心房癌栓的动脉内化疗栓塞治疗[J].介入放射学杂志, 2012, 21 (12) :1035-1038. [3]LIU R, WANG JH, YAN ZP, et al.DSA manifestation of primary liver cancer with tumor thrombus in the right atrium[J].China Cancer, 2000, 9 (9) :425-426. (in Chinese) 刘嵘, 王建华, 颜志平, 等.原发性肝癌伴右心房癌栓DSA表现[J].中国肿瘤, 2000, 9 (9) :425-426. [4]YE XM, LEI JM.Value of ultrasound in diagnosis of tumor thrombus in the right atrium[J].Chin J Med Imaging, 2005, 13 (6) :460-461. (in Chinese) 叶新民, 雷建明.超声对右心房癌栓的诊断价值[J].中国医学影像学杂志, 2005, 13 (6) :460-461. [5]CAO G, ZHANG GS, XU WJ, et al.Imaging findings of hepatocellular carcinoma invasion to right atrial and therapeutic efficacy of transcatheter arterial chemoembolization[J].J Clin Radiol, 2011, 30 (1) :86-89. (in Chinese) 曹刚, 张根山, 徐文杰, 等.原发性肝癌并右心房癌栓的影像学表现及动脉化疗栓塞疗效观察[J].临床放射学杂志, 2011, 30 (1) :86-89. [6]GUO Y, CHEN GH.Diagnosis and treatment of hepatocellular carcinoma complicated by tumor thrombus in the hepatic vein, inferior vena cava, and right atrium[J/CD].Chin J Hepatic Surg:Electronic Edition, 2013, 2 (1) :53-55. (in Chinese) 郭宇, 陈规划.肝细胞肝癌合并肝静脉、下腔静脉及右心房癌栓的诊断与治疗[J/CD].中华肝脏外科手术学电子杂志, 2013, 2 (1) :53-55. [7]CEHNG HY, XU AM, CHEN D, et al.Multi-slice helical CT findings of tumor thrombus in the right atrium from hepatocellular carcinoma[J].Chin J Radiol, 2003, 37 (11) :989-991. (in Chinese) 程红岩, 徐爱民, 陈栋, 等.右心房转移性肝癌的多层螺旋CT表现[J].中华放射学杂志, 2003, 37 (11) :989-991. [8]CHEN SH, ZHAO XY, GAN LS, et al.Ultrasound findings of liver cancer complicated by tumor thrombus in the inferior vena cava and right atrium:a case report[J].J Ultrasound in Clin Med, 2013, 15 (7) :515. (in Chinese) 陈四华, 赵兴燕, 甘伦胜, 等.肝癌伴下腔静脉及右心房癌栓超声表现1例[J].临床超声医学杂志, 2013, 15 (7) :515. [9]OKADA S.How to manage hepatic vein tumour thrombus in hepatocellular carcinoma[J].J Gastroenterol Hepatol, 2000, 15 (4) :346-348. [10]KAWAMOTO K, EGUCHI H, WADA H, et al.A case of successful surgical resection followed by S-1 administration for hepatocellular carcinoma with lung metastases and a tumor thrombus into right atrium[J].Gan To Kagaku Ryoho, 2011, 38 (12) :2490-2492. [11]QIAN XJ, HE T, WAN BS, et al.Hepatocellular carcinoma complicated with tumor thrombus in right atrium and inferior vena cava through liver cancer resection combined with eliminating cancer thrombus:one case report[J].Chin J Gastroenterol Hepatol, 2016, 25 (12) :1352-1354. (in Chinese) 钱相君, 贺涛, 万百顺, 等.肝细胞癌合并右心房及下腔静脉癌栓行肝癌切除联合右心房、下腔静脉取癌栓1例报道[J].胃肠病学和肝病学杂志, 2016, 25 (12) :1352-1354. [12]FUJISAKI M, KURIHARA E, KIKUCHI K, et al.Hepatocellular carcinoma with tumor thrombus extending into the right atrium:report of a successful resection with the use of cardiopulmonary bypass[J].Surgery, 1991, 109 (2) :214-219. [13]WANG Y, YUAN L, GE RL, et al.Survival benefit of surgical treatment for hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus:results of a retrospective cohort study[J].Ann Surg Oncol, 2013, 20 (3) :914-922. [14]MA M, NIU TT, SHAO L, et al.Hepatic transcatheter arterial chemoembolization combined with stereotactic radia-tion therapy of primary liver cancer[J].Trauma and Crit Medicine, 2017, 5 (1) :32-35. (in Chinese) 马明, 牛婷婷, 邵亮, 等.肝动脉化疗栓塞术联合立体定向放疗治疗较大原发性肝癌临床研究[J].创伤与急危重病医学, 2017, 5 (1) :32-35. [15]JIANG GM, ZHAO JW, TIAN F, et al.Interventional treatment of primary liver cancer complicated by tumor thrombus in the inferior vena cava and right atrium:an analysis of 12 cases[J/CD].Chin J Clinicians:Electronic Edition, 2011, 5 (2) :593-595. (in Chinese) 蒋国民, 赵进委, 田丰, 等.原发性肝癌合并下腔静脉及右心房癌栓12例的介入治疗[J/CD].中华临床医师杂志:电子版, 2011, 5 (2) :593-595. [16]Ministry of Health of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2011) [J].J Clin Hepatol, 2011, 27 (11) :1141-1159. (in Chinese) 中华人民共和国卫生部.原发性肝癌诊疗规范 (2011年版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1159. [17]HE YM, HOU B.PEG-IFNα-2a and ribavirin for decompensated cirrhotic patients with hepatitis C after eliminating complications[J].Chin J Med Offic, 2017, 45 (4) :397-400. (in Chinese) 何妍梅, 侯波.聚乙二醇干扰素α-2a联合利巴韦林治疗失代偿期丙肝肝硬化并发症消除后患者观察[J].临床军医杂志, 2017, 45 (4) :397-400. [18]REIG M, MARINO Z, PERELLO C, et al.Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy[J].J Hepatol, 2016, 65 (4) :719-726. [19]ANRS collaborative study group on hepatocellular carcinoma (ANRS CO22 HEPATHER, CO12 Cir Vir and CO23 CUPILT cohorts) .Lack of evidence of an effect of direct-acting antivirals on the recurrence of hepatocellular carcinoma:data from three ANRS cohorts[J].J Hepatol, 2016, 65 (4) :734-740. [20]LEE SH, JIN YJ, SHIN JY, et al.Assessment of hepatocellular carcinoma risk based on peg-interferon plus ribavirin treatment experience in this new era of highly effective oral antiviral drugs[J].Medicine (Baltimore) , 2017, 96 (1) :e5321. [21]FOSTER GR, IRVING WL, CHEUNG MC, et al.Impact of direct acting antiviral therapy in patients with chronic hepatitis C and decompensated cirrhosis[J].J Hepatol, 2016, 64 (6) :1224-1231. [22]CHEN P, LI F.New progress in treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].J Clin Hepatol, 2015, 31 (6) :974-976. (in Chinese) 陈鹏, 李菲.肝细胞癌合并门静脉癌栓治疗新进展[J].临床肝胆病杂志, 2015, 31 (6) :974-976. [23]DONG J, JIANG JJ.Explanation of the“recommendation on antiviral therapy to hepatitis B/C virus related hepatocellular carcinoma”[J].J Clin Hepatol, 2013, 29 (1) :20-24. (in Chinese) 董菁, 江家骥.《HBV/HCV相关性肝细胞癌抗病毒治疗专家建议》解读[J].临床肝胆病杂志, 2013, 29 (1) :20-24.
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