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目的 研究原发性肝癌肝动脉化疗栓塞 (TACE)对肝硬化的形成作用。材料与方法 动态观察 46例原发性肝癌患者TACE前后血清中HA(透明质酸 )、HPC Ⅲ (人三型前胶原 )、Ⅳ·C(四型胶原 )、LN(层粘蛋白 ) 4项肝纤维化血清学指标的含量变化 ,并依据化疗栓塞导管端位置分为 2组 ,一组 3 0例导管端位于肝固有动脉 ,另一组 16例导管端位于肝节段动脉。结果 肝固有动脉组 ,首次TACE前后上述 4项指标含量无明显差异 (P >0 .0 5 ) ,而第 2次TACE后 ,可见 4项指标含量明显高于术前 (P <0 .0 5 ) ,尤其是第 3次治疗后 ,可见上述指标含量大幅度明显升高 (P <0 .0 1)。而肝节段动脉组 ,TACE前后上述指标的含量无明显差异 (P >0 .0 5 )。结论 原发性肝癌TACE后肝纤维化的形成与化疗栓塞时所选择的靶血管相关 ,应引起足够重视 ,对指导肝癌的TACE治疗 ,提高患者的预后具有重要意义。
Objective To study the effect of hepatocellular arterial chemoembolization (TACE) on the formation of liver cirrhosis. Materials and Methods Dynamic observation of serum HA (hyaluronic acid), HPC III (human type III procollagen), IV·C (type IV collagen), LN (laminin) in serum of 46 patients with primary liver cancer before and after TACE The content of serological markers of hepatic fibrosis was changed and divided into two groups according to the location of the catheter end of chemoembolization. One group of 30 catheter ends were located in the proper hepatic artery, and the other group of 16 catheter ends were located in the liver segment arteries. Results There was no significant difference in the content of the above four parameters before and after the first TACE in the proper hepatic arterial group (P > 0.05). After the second TACE, the content of the four indexes was significantly higher than that before the operation (P < 0.05). ), especially after the third treatment, the content of the above indicators was significantly increased (P < 0.01). In the segmental arteries of the liver, there was no significant difference in the above indexes before and after TACE (P > 0.05). Conclusion The formation of hepatic fibrosis after TACE in primary hepatocellular carcinoma is related to the target vessel selected during chemoembolization. It should be paid enough attention to guide the TACE treatment of hepatocellular carcinoma and improve the prognosis of patients.