DEVELOPMENT OF PORTAL-VEIN INVASION AND ITS OUTCOME IN HEPATOCELLULAR-CARCINOMA TREATED BY TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
DEVELOPMENT OF PORTAL-VEIN INVASION AND ITS OUTCOME IN HEPATOCELLULAR-CARCINOMA TREATED BY TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
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DOI：
10.1111/j.1440-1746.1994.tb01207.x
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发表时间：
1994-01-01
影响因子：
4.1
通讯作者：
CHANG, WY
中科院分区：
文献类型：
--
作者：
CHEN, SC;HSIEH, MY;CHANG, WY
肝细胞癌是世界上最常见的恶性肿瘤之一。一个严重的并发症是门静脉的侵犯。为探讨经导管动脉化疗栓塞术(TACE)治疗后肝细胞癌门静脉的新侵袭情况，对124例肝细胞癌患者进行了超声、CT和血管造影检查。15名患者在最初的检查中被诊断为门静脉侵犯(PVI)，并被排除在研究之外。在其余109例患者中，有18例发生了PVI。其中14人为男性，4人为女性。18例患者中无一例对TACE治疗完全有效，均复发。首次TACE后出现PVI的中位时间为212天。PVI与上次超声检查的中位间隔时间为100天。两者均与PVI程度相关。影响PVI出现时间的唯一重要因素是TACE治疗。发生PVI后，8例患者继续接受TACE治疗，其中3例患者同时行门静脉局部化疗。2例患者PVI消退。发现PVI后的中位生存期为129天。影响患者生存时间的因素有：功能状态、Pugh分级、性别、肿瘤侵袭面积和继续治疗。
Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. One serious complication is the invasion of the portal vein. To investigate the new invasion of the portal vein in HCC following treatment by transcatheter arterial chemo-embolization (TACE), 124 patients with HCC were screened by ultrasound, computed tomography and angiography. Fifteen patients were diagnosed with portal vein invasion (PVI) during the initial examination and were excluded from the study. Of the remaining 109 patients, 18 developed PVI. Fourteen were male and four were female. None of these 18 patients completely responded to TACE treatment and all were in recurrence. The median time for appearance of PVI after the first TACE was 212 days. The median interval between PVI and the last negative ultrasound examination was 100 days. Both were correlated with the degree of PVI. The only significant factor affecting the time until the appearance of PVI was the TACE treatment. After the development of PVI, eight patients continued with the TACE treatment, and three of these patients were also treated with portal vein local chemotherapy. The regression of PVI was observed in two patients. The median survival time after the discovery of PVI was 129 days. Factors affecting the survival time were performance state, Pugh classification, sex, the area of tumour invasion and continued treatment.