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目的：评价TACE治疗肝癌合并门脉瘤栓的疗效。材料与方法：经TACE治疗的合并门脉瘤栓的HCC患者59冽，主干瘤检29例，一级分支瘤栓30例。根据栓塞方法分为：GS组（n＝21）、LP组（n＝10）、混合组（n＝28）。分别以瘤栓变化及生存时间作为近、远期疗效评价指标。结果：3组近期疗效有效率分别为38．1％，0％，50％，GS组及混合组疗效优于LP组（p＜0．05）；3种TACE方法对门脉瘤栓缩小的有效率分别为GsTACE50％、LpTA5．7％，LpGsTACE24．1％，GsTACE疗效优于后两者（p＜0．05）；混合组远期疗效优于另两组（p＜0．05），其3，612个月生存率分别为89．2％，52．0％，18．6％；近期疗效有效组生存率优于无效组（p＜0．01），有效组3、6、12个月生存率分别为100％，59．1％，19．8％。结论：对于合并门脉瘤栓的HCC患者，应用Gs的TACE治疗效果优于无Gs的TACE治疗。GsTACE应作为门脉瘤栓治疗的首选方法。
Objective: To evaluate the efficacy of TACE in the treatment of hepatocellular carcinoma with portal vein thrombus. Materials and Methods: TACE-treated HCC patients with portal vein tumor thrombus were included in 59 cases of HCC, 29 cases of major tumors, and 30 cases of primary branch tumor thrombi. According to embolization methods, they were divided into GS group (n=21), LP group (n=10), and mixed group (n=28). The changes of tumor thrombus and survival time were taken as the evaluation indicators of the short-term and long-term curative effects. Results: The curative effect of three groups was 38.1%, 0%, and 50% respectively. The curative effect of GS group and mixed group was better than that of LP group (p<0.05). The 3 kinds of TACE methods reduced the portal thromboembolism. The effective rates were 50% for GsTACE, 5.7% for LpTA, and 24.1% for LpGsTACE. The efficacy of GsTACE was better than the latter two (p<0.05); the long-term efficacy of the mixed group was better than that of the other two groups (p<0.05). The 3,612-month survival rates were 89.2%, 52.0%, and 18.6% respectively; the efficacy-effective group had better survival than the ineffective group (p<0.01), and the effective group 3, 6, and 12 The monthly survival rates were 100%, 59.1%, and 19.8%, respectively. Conclusion: For HCC patients with portal vein tumor thrombus, TACE treatment with Gs is superior to TACE treatment without Gs. GsTACE should be the first choice for portal vein thrombus therapy.