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目的评价原发性肝癌(PHCC)术前肝动脉化疗栓塞术(TACE)的价值。方法2116例不能手术切除的PHCC患者经TACE治疗后,有41例获Ⅱ期手术切除,分析其TACE特点、距手术时间、病理学改变和随访情况。结果TACE术可使1.9%的PHCC患者获得Ⅱ期手术切除,手术切除前平均TACE治疗次数2.3次/人,距手术时间平均45天;TACE有效率(CR+PR)为51.2%。肿瘤完全坏死4例,占9.9%;重度介入治疗后反应27例;肿瘤残留呈弥漫分布或肿瘤周边被膜下。1、2、3、5年生存率85.0%、74.3%、57.6%和46.2%。中位生存期50.3个月。结论术前TACE治疗可使部分不能手术切除的HCC患者获Ⅱ期手术切除,其疗效肯定,是延长患者生存期的有效方法。
Objective To evaluate the value of preoperative hepatic artery chemoembolization (TACE) in patients with primary liver cancer (PHCC). Methods Twenty-one cases of unresectable PHCC patients after TACE were treated by TACE, and 41 cases underwent stage Ⅱ resection. The characteristics of TACE were analyzed, and the operation time, pathological changes and follow-up were analyzed. Results In TACE group, 1.9% of PHCC patients underwent stage Ⅱ resection. The average number of TACE treatments before surgery was 2.3 times per person, and the mean operative time was 45 days. The TACE effective rate (CR + PR) was 51.2%. Tumor completely necrosis in 4 cases, accounting for 9.9%; 27 cases after severe intervention response; tumor residues were diffuse distribution or tumor surrounding capsule. The 1, 2, 3, 5-year survival rates were 85.0%, 74.3%, 57.6% and 46.2% respectively. The median survival time was 50.3 months. Conclusions Preoperative TACE treatment can make partially unresectable HCC patients obtain surgical resection in stage Ⅱ, and its curative effect is definite, which is an effective method to prolong the survival of patients.