Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy
Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy
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DOI：
10.1007/s00534-007-1288-4
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发表时间：
2008-11-01
期刊：
影响因子：
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通讯作者：
Baba, Hideo
中科院分区：
文献类型：
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作者：
Masuda, Toshiro;Beppu, Toru;Baba, Hideo
为探讨肝细胞癌局部消融治疗(LAT)后肝内扩散的组织学特点及危险因素，自1992年4月至2005年12月，我科共收治了192例肝细胞癌患者，其中17例局部复发。这17名患者中有8名患者有肝内播散。对8例经手术治疗的肝内播散性肿瘤患者的临床和组织学特点进行了分析，组织学上可见大量肝内转移灶，主要位于与治疗肿瘤相同的层面，并伴有门静脉主干或节段性癌栓。消融治疗前肿瘤平均直径为2.1 cm，62.5%的肿瘤邻近门静脉主干或节段。在治疗因素方面，25%的患者以前有过针吸活检，62.5%的患者安全边界不足。肝细胞癌(即使是直径小于3 cm的肝细胞癌)在距离门静脉主干或门静脉截面小于5 mm的地方进行LAT可能会促进肝内扩散。
We aimed to clarify the histological features of and risk factors for intrahepatic dissemination after local ablation therapy (LAT) for hepatocellular carcinoma (HCC).Between April 1992 and December 2005, 192 HCC patients underwent hepatic resection at our department, among whom were 17 patients who had local recurrences after LAT. Eight of these 17 patients had intrahepatic dissemination. The clinical and histological characteristics of these 8 surgically treated patients with intrahepatic dissemination were investigated.Histologically, numerous intrahepatic metastases were observed, mainly in the same section as the treated tumor, together with main or sectional portal vein tumor thrombi. Before the ablation therapy, the average tumor diameter was 2.1 cm, and 62.5% of the tumors were adjacent to the main or sectional portal vein. In terms of therapeutic factors, 25% of the patients had a prior needle biopsy and 62.5% had insufficient safety margins.LAT for HCCs (even those less than 3 cm in diameter) adjacent less than 5 mm to the main or sectional portal vein possibly promotes intrahepatic dissemination.