CAJ | 학술논문

目的探讨肝细胞癌( hepatocellular carcinoma,HCC)根治性切除术后残肝创面植入氟尿嘧啶微粒(5 fluorouracil,5-FU)对预防术后复发的价值.方法回顾分析2007年3月至2008年3月184例HCC(单发,直径≤5 cm,无肉眼癌栓)行肝切除患者的临床资料.患者分为2组,用药组90例,术中肝创面植入5-FU,对照组94例,术中未植入5-FU.术后随访患者复发情况.结果用药组与对照组患者中位无瘤生存时间分别为43个月和35个月,用药组术后1、2、3年的无瘤生存率为86％、76％、64％,对照组为77％、61％、49％,2组比较差异有统计学意义(x2 =4.77,P＜0.05).2组患者术后第7天肝肾功能主要指标(总胆红素、血清白蛋白、丙氨酸转氨酶、尿素氮、血清肌苷)以及术后并发症比较,差异无统计学意义(P＞0.05).结论 HCC肝切除术后,残肝创面植入5-FU微粒,可显著提高HCC的无瘤生存率,对患者肝肾功能无显著影响,不增加术后并发症发生率.
목적 탐토간세포암( hepatocellular carcinoma,HCC)근치성절제술후잔간창면식입불뇨밀정미립(5 fluorouracil,5-FU)대예방술후복발적개치.방법 회고분석2007년3월지2008년3월184례HCC(단발,직경≤5 cm,무육안암전)행간절제환자적림상자료.환자분위2조,용약조90례,술중간창면식입5-FU,대조조94례,술중미식입5-FU.술후수방환자복발정황.결과 용약조여대조조환자중위무류생존시간분별위43개월화35개월,용약조술후1、2、3년적무류생존솔위86％、76％、64％,대조조위77％、61％、49％,2조비교차이유통계학의의(x2 =4.77,P＜0.05).2조환자술후제7천간신공능주요지표(총담홍소、혈청백단백、병안산전안매、뇨소담、혈청기감)이급술후병발증비교,차이무통계학의의(P＞0.05).결론 HCC간절제술후,잔간창면식입5-FU미립,가현저제고HCC적무류생존솔,대환자간신공능무현저영향,불증가술후병발증발생솔.
Objective To evaluate embedding 5-FU microparticles during operation after hepatectomy for small hepatocellular carcinoma to prevent recurrence. Methods A retrospective analysis on 184 patients was done.All patients received liver resection for HCC from 2007 Mar.to 2008 Mar.In 90 cases,5-FU releasing microparticles were embeded on liver cutting surface after the tumor was resected (group A).94 cases in which no micropaticles were given served as controls (group B).All patients had a single tumor( ≤5 cm) without visible vessel invasion. Results The postoperative disease-free survival ( DFS),and median period of DFS of group A vs.group B was 43 months vs 35 months.Postoperative DFS rates of 1-,2-and 3-year were 86％,76％％ and 64％ respectively in A group,while they were 77％,61％and 49％ respectively in B group ( x2 =4.77,P ＜ 0.05 ).In two groups the liver and kidney main function index( TB,ALB,ALT,BUN,Scr)on day 7 and postoperative complications were not statistically different (P ＞ 0.05 ). Conclusions Embeding 5-FU microparticle after hepatectomy for HCC could increase the postoperative DFS rates,and patients do not suffer from significant liver and kidney malfunctions.