CAJ | 학술논문

目的探讨经导管动脉化疗性栓塞(TACE)结合Ⅱ期手术切除治疗巨块型外生型肝细胞癌(E-HCC)的可行性.方法对5例E-HCC患者,先行TACE.术后1个月复查,CT显示病灶内碘油沉积欠佳者再行动脉造影和TACE术.待肿瘤缩小而不能经动脉途径有效给药时,行Ⅱ期手术切除.结果 5例患者行TACE共9次,平均1.8次.全部病例于TACE后1个月行CT检查,碘油在瘤体沉积表现为3型:完全填充型1例、致密型3例、斑片或环状型1例.5例患者均行Ⅱ期手术切除,3例成功行根治切除,2例因周边组织受侵、粘连严重而行姑息性切除.术后病理显示肿瘤有35%～100%(平均74.8%)的坏死.随访13～27月,1例存活,4例死亡,平均生存期为22.2月.无严重手术并发症发生.结论 TACE可使E-HCC坏死、缩小,提高Ⅱ期手术切除的机会.
목적 탐토경도관동맥화료성전새(TACE)결합Ⅱ기수술절제치료거괴형외생형간세포암(E-HCC)적가행성.방법 대5례E-HCC환자,선행TACE.술후1개월복사,CT현시병조내전유침적흠가자재행동맥조영화TACE술.대종류축소이불능경동맥도경유효급약시,행Ⅱ기수술절제.결과 5례환자행TACE공9차,평균1.8차.전부병례우TACE후1개월행CT검사,전유재류체침적표현위3형:완전전충형1례、치밀형3례、반편혹배상형1례.5례환자균행Ⅱ기수술절제,3례성공행근치절제,2례인주변조직수침、점련엄중이행고식성절제.술후병리현시종류유35%～100%(평균74.8%)적배사.수방13～27월,1례존활,4례사망,평균생존기위22.2월.무엄중수술병발증발생.결론 TACE가사E-HCC배사、축소,제고Ⅱ기수술절제적궤회.
Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) in combination with secondary resection in the treatment of massive extrahepatic growing hepatocellular carcinoma (E-HCC). Methods Five patients were involved in this study. CT reviewed after the first time of TACE treatment a month. If the lesion was not filled with satisfaction by chemotherapic agents lipiodol emulsion, arterial angiography and TACE were performed again. If failed to inject chemotherapic agents lipiodol emulsion into the lesions through the feeding arteries, the secondary resection was used. Results Five patients underwent TACE treatment 9 times, an average of 1.8 times. CT reviewed the iodized oil deposition in the tumor showed 3 types after all patient were treated first time of TACE a month: completely filled 1 case; dense filled 3 cases; spot or ring-type filled 1 case. After received the secondary resection, 3 cases of them were underwent curative resection successfully, the other 2 cases were used palliative resection due to surrounding tissue severe adhesion. Post-operative pathological specimen showed 35%～100% tumor necrosis (average 74.8%). During a follow-up of 13～27 months, 1 survived and 4 deaths, the median survival time was 22.2 months. No severe complications were observed. Conclusion TACE can induce obvious necrosis and shrinkage of E-HCC and increase the opportunities of secondary resection.