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目的研究经导管动脉化疗栓塞(TACE)治疗肝细胞癌(HCC)的疗效及对HCC预后的影响。方法经手术病理证实的HCC患者139例,其中TACE组81例,单纯手术组58例。用末端脱氧核苷转移酶介导的dUTP毛地黄毒素缺口末端标记(TUNEL)法检测凋亡细胞,用免疫组化检测各标本bcl2、bax、p53、增殖细胞核抗原(PCNA)和Ki67蛋白表达,分析两组的肿瘤标志物改变、肿瘤坏死、包膜形成、体积、复发转移率及累计生存率。结果TACE可使肿瘤包膜形成、体积缩小,引起肿瘤坏死,诱导细胞凋亡,导致增殖转移潜能下降。TACE组患者的中位生存期为803.3d,1,2,3年生存率分别为84.0%、67.9%和40.7%;单纯手术组患者的中位生存期为742.5d,1,2,3年生存率分别为72.4%、55.2%和24.1%(P<0.05)。结论TACE治疗HCC安全有效,可改善患者的生存率。
Objective To investigate the curative effect of transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC) and its effect on the prognosis of HCC. Methods 139 cases of HCC confirmed by surgery and pathology, including 81 cases of TACE group, 58 cases of simple surgery group. Apoptotic cells were detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), and the expressions of bcl2, bax, p53, PCNA and Ki67 were detected by immunohistochemistry. Tumor marker changes, tumor necrosis, capsule formation, volume, recurrence and metastasis, and overall survival were analyzed in both groups. Results TACE can make the tumor envelope formation, reduce the volume, cause tumor necrosis, induce apoptosis and lead to the decrease of proliferation and metastasis potential. The median survival time was 803.3 days in TACE group and 84.0%, 67.9% and 40.7% in 1, 2, 3 years respectively. The median survival time in patients in simple surgery group was 742.5 days, 1, 2, 3 years Survival rates were 72.4%, 55.2% and 24.1%, respectively (P <0.05). Conclusion TACE treatment of HCC safe and effective, can improve the survival rate of patients.