中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素

邢爱丽 郑加生

邢爱丽, 郑加生. 经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素[J]. 临床肝胆病杂志, 2019, 35(1): 98-103. DOI: 10.3969/j.issn.1001-5256.2019.01.018.
引用本文: 邢爱丽, 郑加生. 经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素[J]. 临床肝胆病杂志, 2019, 35(1): 98-103. DOI: 10.3969/j.issn.1001-5256.2019.01.018.
Xing AiLi, Zheng JiaSheng. Clinical effect of transcatheter arterial chemoembolization combined with local thermal ablation in treatment of large hepatocellular carcinoma and related influencing factors[J]. J Clin Hepatol, 2019, 35(1): 98-103. DOI: 10.3969/j.issn.1001-5256.2019.01.018.
Citation: Xing AiLi, Zheng JiaSheng. Clinical effect of transcatheter arterial chemoembolization combined with local thermal ablation in treatment of large hepatocellular carcinoma and related influencing factors[J]. J Clin Hepatol, 2019, 35(1): 98-103. DOI: 10.3969/j.issn.1001-5256.2019.01.018.

经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素

DOI: 10.3969/j.issn.1001-5256.2019.01.018
基金项目: 

国家科技支撑计划课题任务书(2012BAI15B00); 

详细信息
  • 中图分类号: R735.7

Clinical effect of transcatheter arterial chemoembolization combined with local thermal ablation in treatment of large hepatocellular carcinoma and related influencing factors

Research funding: 

 

  • 摘要:

    目的探讨经肝动脉化疗栓塞术(TACE)联合局部热消融治疗大肝癌的临床效果。方法回顾性分析2010年1月-2016年9月在首都医科大学附属北京佑安医院肿瘤微创介入中心接受TACE联合局部热消融治疗的大肝癌患者的临床资料,134例患者中行TACE联合微波消融治疗75例,行TACE联合射频消融治疗共59例。评价患者的消融效果(分为完全消融和部分消融),随访获得完全消融的患者肝内肿瘤复发状况。采用χ2检验和logistic回归分析消融效果的影响因素;采用Kaplan-Meier生存分析和Cox比例风险模型统计其中位无复发生存期并分析影响因素。结果在全部患者中,有88例获得完全消融,46例为部分消融,完全消融率为65. 7%,logistic回归分析分析显示,合并门静脉癌栓[比值比(OR)=5. 051,P=0. 017],肿瘤包膜不完整(OR=4.199,P=0. 007)及肿瘤位于危险部位(OR=4. 967,P=0. 001)是影响消融效果的独立危险因素。获得完全消融的患者其中位无复发生存期是(17. 41±2. 73)个月,1、3、5年的无复发生存率分别为61. 4%、23. 3%和17...

     

  • [1]FORNER A, REIG M, BRUIX J.Hepatocellular carcinoma[J].The Lancet, 2018, 391 (10127) :1301-1314.
    [2]BALOGH J, VICTOR DR, ASHAM EH, et al.Hepatocellular carcinoma:A review[J].J Hepatocell Carcinoma, 2016, 3:41-53.
    [3]GUIMARAES M, UFLACKER R.Locoregional therapy for hepatocellular carcinoma[J].Clin Liver Dis, 2011, 15 (2) :395-421.
    [4]SHI J, SUN Q, WANG Y, et al.Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria[J].J Gastroenterol Hepatol, 2014, 29 (7) :1500-1507.
    [5]HOCQUELET A, BALAGEAS P, LAURENT C, et al.Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria:A study of 281 Western patients[J].Int J Hyperthermia, 2015, 31 (7) :749-757.
    [6]LEE DH, LEE JM, LEE JY, et al.Radiofrequency ablation of hepatocellular carcinoma as first-line treatment:Long-term results and prognostic factors in 162 patients with cirrhosis[J].Radiology, 2014, 270 (3) :900-909.
    [7]GUO XD, SUN SS, LI WD, et al.Effects of transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation on patients with intermediate stage primary liver cancer[J/CD].Chin J Liver Dis:Electronic Edition, 2018, 10 (2) :30-36. (in Chinese) 郭晓笛, 孙莎莎, 李文东, 等.肝动脉化疗栓塞术联合射频消融术治疗中期原发性肝癌患者的疗效[J/CD].中国肝脏病杂志:电子版, 2018, 10 (2) :30-36.
    [8]XU Y, SHEN Q, WANG N, et al.Percutaneous microwave ablation of 5-6 cm unresectable hepatocellular carcinoma:Local efficacy and long-term outcomes[J].Int J Hyperthermia, 2016.[Epub ahead of print]
    [9]YIN XY, XIE XY, LU MD, et al.Percutaneous thermal ablation of medium and large hepatocellular carcinoma:Long-term outcome and prognostic factors[J].Cancer, 2009, 115 (9) :1914-1923.
    [10]ZHAI B.Strategy and prospect of thermal ablation for treatment of large hepatocellular carcinoma[J/CD].Eletronic JLiver Tumor, 2017, 4 (4) :13-16. (in Chinese) 翟博.大肝癌热消融治疗策略及展望[J/CD].肝癌电子杂志, 2017, 4 (4) :13-16.
    [11]CHEN WY, REN N.Advances in molecular targeted therapy for hepatocellular carcinoma[J].J Clin Hepatol, 2018, 34 (7) :1387-1394. (in Chinese) 陈万勇, 任宁.肝细胞癌分子靶向治疗进展[J].临床肝胆病杂志, 2018, 34 (7) :1387-1394.
    [12]TAKAKI H, YAMAKADO K, URAKI J, et al.Radiofrequency ablation combined with chemoembolization for the treatment of hepatocellular carcinomas larger than 5 cm[J].J Vasc Interv Radiol, 2009, 20 (2) :217-224.
    [13]LIM C, MISE Y, SAKAMOTO Y, et al.Above 5 cm, size does not matter anymore in patients with hepatocellular carcinoma[J].World J Surg, 2014, 38 (11) :2910-2918.
    [14]DELIS SG, BAKOYIANNIS A, TASSOPOULOS N, et al.Hepatic resection for hepatocellular carcinoma exceeding Milan criteria[J].Surg Oncol, 2010, 19 (4) :200-207.
    [15]CHANG YJ, CHUNG KP, CHANG YJ, et al.Long-term survival of patients undergoing liver resection for very large hepatocellular carcinomas[J].Br J Surg, 2016, 103 (11) :1513-1520.
    [16]ZHANG W, TAN Y, JIANG L, et al.Liver resection associated with better outcomes for single large hepatocellular carcinoma located in the same section[J].Medicine (Baltimore) , 2017, 96 (10) :e6246.
    [17]SONG SH, GUO J, ZOU C.Factors influencing postoperative recurrence in patients with primary liver cancer after hepatectomy[J].J Pract Hepatol, 2017, 20 (2) :203-206. (in Chinese) 宋书红, 郭俊, 邹灿.肝癌手术切除术后复发相关因素分析[J].实用肝脏病杂志, 2017, 20 (2) :203-206.
    [18]IEZZI R, POMPILI M, LA TORRE MF, et al.Radiofrequency ablation plus drug-eluting beads transcatheter arterial chemoembolization for the treatment of single large hepatocellular carcinoma[J].Dig Liver Dis, 2015, 47 (3) :242-248.
    [19]SHI M, ZHANG CQ, ZHANG YQ, et al.Micrometastases of solitary hepatocellular carcinoma and appropriate resection margin[J].World J Surg, 2004, 28 (4) :376-381.
    [20]REN ZG.Immunotherapy for hepatocellular carcinoma[J].JClin Hepatol, 2018, 34 (7) :1371-1373. (in Chinese) 任正刚.肝细胞癌的免疫治疗[J].临床肝胆病杂志, 2018, 34 (7) :1371-1373.
    [21]XU LF, SUN HL, CHEN YT, et al.Large primary hepatocellular carcinoma:Transarterial chemoembolization monotherapy versus combined transarterial chemoembolization-percutaneous microwave coagulation therapy[J].J Gastroenterol Hepatol, 2013, 28 (3) :456-463.
    [22]BIOLATO M, MARRONE G, RACCO S, et al.Transarterial chemoembolization (TACE) for unresectable HCC:A new life begins?[J].Eur Rev Med Pharmacol Sci, 2010, 14 (4) :356-362.
    [23]TANG C, SHEN J, FENG W, et al.Combination therapy of radiofrequency ablation and transarterial chemoembolization for unresectable hepatocellular carcinoma:A retrospective study[J].Medicine (Baltimore) , 2016, 95 (20) :e3754.
    [24]CHANG P, ZHANG HY, XIAO M.Efficacy of transcatheter arterial chemoembolization alone or combined with microwave ablation in treatment of primary large liver cancer:A comparetive analysis[J].J Clin Hepatol, 2015, 31 (6) :880-885. (in Chinese) 常鹏, 张洪义, 肖梅.单纯经肝动脉化疗栓塞术及其联合微波消融治疗原发性大肝癌的疗效对比分析[J].临床肝胆病杂志, 2015, 31 (6) :880-885.
  • 期刊类型引用(21)

    1. 王义大. 肝癌肿瘤切除术后患者应用肝动脉介入化疗栓塞术治疗的效果观察. 现代养生. 2024(07): 520-522 . 百度学术
    2. 耿鹏,付强,卢钟琦,常颖,张美花,金蕴. 肝癌热消融的研究热点和趋势可视化分析. 介入放射学杂志. 2024(08): 870-875 . 百度学术
    3. 郭文涛,汶芙蓉,李继昌. 经导管动脉栓塞化疗联合局部热消融治疗大肝癌的临床疗效及对患者肝功能和预后的影响. 癌症进展. 2023(01): 108-110 . 百度学术
    4. 王宪,吕海茹. 超声引导经皮穿刺微波消融联合无水酒精对3~5 cm原发性肝癌的疗效及复发影响因素. 山西医药杂志. 2023(04): 260-264 . 百度学术
    5. 杨占祥,张坤. 经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素. 贵州医药. 2023(07): 1052-1053 . 百度学术
    6. 王文轩,张福洲,徐晓雪,杨汉丰. 对比TACE联合射频消融与联合微波消融治疗原发性肝细胞癌效果:Meta分析. 中国介入影像与治疗学. 2023(08): 467-472 . 百度学术
    7. 谢秋霞. 原发性肝癌患者肝动脉化疗栓塞术后复发的危险因素分析. 当代护士(上旬刊). 2023(06): 39-41 . 百度学术
    8. 郑爱枝,王光霞,张毓珍. 肝动脉化疗栓塞联合阿帕替尼治疗中晚期肝癌的效果和安全性. 中国实用医刊. 2022(02): 20-23 . 百度学术
    9. 王朝英,徐军,罗靖茹,林海锋. 原发性老年肝癌患者TACE前后miR-145、CD44变化及近期疗效. 中国老年学杂志. 2022(14): 3419-3423 . 百度学术
    10. 王颖. 彩超引导介入射频消融治疗肝脏肿瘤的临床应用分析. 中国医疗器械信息. 2022(20): 77-79 . 百度学术
    11. 韩国华,方康,刘春光. TACE序贯联合微波消融术与TACE治疗大肝癌临床疗效及安全性比较. 潍坊医学院学报. 2022(06): 457-460 . 百度学术
    12. 祖亮,杨栋云,高杨,应希慧,赵中伟. 经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素. 中国现代医生. 2021(18): 100-103 . 百度学术
    13. 李虎子,段振东,赵成,方文岩,张洪,贺斌,李悦. TACE联合冷冻消融治疗不可切除肝癌临床疗效的meta分析. 介入放射学杂志. 2021(08): 804-813 . 百度学术
    14. 范隼,钟鹏,巫兆国. 经肝动脉化疗栓塞联合同步射频消融术治疗肝癌的初步临床研究. 吉林医学. 2021(10): 2389-2390 . 百度学术
    15. 邱艳,赖娟,占魁. 异常凝血酶原联合甲胎蛋白异质体在乙肝相关性肝癌中的临床意义. 中国当代医药. 2021(33): 173-175 . 百度学术
    16. 曹树伟,张静,兰文婧,张立军,薛明,郭喜田. TACE联合C臂CT引导下微波消融治疗特殊部位原发性肝癌. 中国介入影像与治疗学. 2020(01): 27-30 . 百度学术
    17. 汤金全,何攀,苏松,罗斌,方程,李波,夏先明,李玉伟. 射频消融术和微创切除术治疗小肝细胞癌短期及长期效果比较的Meta分析. 临床肝胆病杂志. 2020(02): 358-362 . 本站查看
    18. 景晓,乔新梅,李楠,符会妮. 碳酸氢钠联合载药微球表柔比星治疗原发性肝癌的短期疗效和安全性研究. 药物评价研究. 2020(06): 1137-1141 . 百度学术
    19. 孙超,孟醒初,董冲,王凯,郑卫萍,覃虹,韩潮,杨洋,张复波,曹顺琪,徐敏,高伟. 小儿血型不合活体肝移植的临床疗效分析. 器官移植. 2020(04): 466-470 . 百度学术
    20. 徐伟,王霞,武子英,孙继泽. 经导管动脉化疗栓塞术联合冷冻消融治疗不可切除性大肝癌患者的效果及对细胞免疫的影响. 中国肿瘤临床与康复. 2019(09): 1039-1042 . 百度学术
    21. 喻祖胜,李国伟,袁年勇. 肝动脉化疗栓塞联合微波消融治疗原发性大肝癌的临床疗效. 肝胆胰外科杂志. 2019(11): 681-683 . 百度学术

    其他类型引用(5)

  • 加载中
计量
  • 文章访问数:  2032
  • HTML全文浏览量:  21
  • PDF下载量:  345
  • 被引次数: 26
出版历程
  • 出版日期:  2019-01-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回