肝移植术后肝癌的介入治疗

目的：观察介入化疗栓塞在肝移植（LT）后肝细胞性肝癌（HCC）复发治疗中的作用。方法：15例原发性HCC肝移植后肿瘤复发且失去外科手术机会的患者接受1次或多次介入化疗栓塞（TACE）治疗。通过影像学资料判定治疗效果,观察患者生存率。结果：15例中2例（13.33%）肿瘤完全消退,10例患者（66.67%）肿瘤体积缩小≥50%。随访期间有11例（73.33%）出现了肝内或肝外新发病灶。移植后1、2和3年生存率分别为86.3%、57.5%和48.5%;复发后0.5、1、1.5、2年生存率分别为70.2%、55.7%、47.2%和38.8%,未出现严重并发症。结论：介入化疗栓塞是肝移植后肝癌复发且失去手术机会的患者可以选择的一种有效、安全的治疗手段,可一定程度地控制肿瘤生长。

Chemoembolization for the hepatocellular carcinoma after liver transplantation

Objective：To observe the effect of chemoembolization for the hepatocellular carcinoma（HCC） after liver transplantation（LT）.Methods：All 15 cases with recurrent HCC after LT and loss the chance of operation underwent one and more cycles of transcatheter arterial chemoembolization（TACE）after LT.The treatment effect was appraised by imaging diagnosis,and observe the survival rate.Results：Of 15 cases 2 cases were complete response,targeted tumor showed a reduction in size by 50% in 10（66.67%） after TACE.However,intrahepatic recurrence or extrahepatic metastasis occurred in 11（73.33%）.The survival rate of 1,2 and 3 years after LT was 86.3%,57.5% and 48.5%.The survival rate of 0.5,1,1.5 and 2 years after LT was 70.2%,55.7%,47.2% and 38.8%.No severe complication developed during follow-up period.Conclusion：TACE is the safe and effective treatment for the patient with recurrent HCC after LT and loss the chance of operation,it would retard the tumor grow up to a certain extent.