南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (08): 1145-.

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肝移植前行肝动脉介入栓塞化疗的远期效果分析

戴敏,周杰,崔忠林,黄坤   

  • 出版日期:2014-08-20 发布日期:2014-08-20

Long-term outcomes of transcatheter arterial chemoembolization before liver
transplantation in patients with hepatocellular carcinoma

  • Online:2014-08-20 Published:2014-08-20

摘要: 目的研究探讨肝移植术前行肝动脉介入栓塞化疗对于术后患者远期疗效的临床价值。方法采取回顾性分析法,选取我
科2009年11月~2011年11月进行肝移植的肝细胞性肝癌(HCC)患者46例,其中24例术前予以肝动脉介入栓塞化疗(TACE),
22例术前未予以TACE治疗。比较两组患者术后1年的肝功能(ALT和AST水平)、免疫功能(CD3、CD4、CD8、CD4/CD8、NK
细胞、活化T细胞比例)、术后1年和术后2年的累计生存率和无瘤生存率。结果术后1年介入组的肝功能显著优于对照组,P<
0.01,免疫功能显著优于对照组,P<0.05;术后1年介入组和对照组的累计无瘤生存率分别为72%和46%,术后2年介入组和对照
组的累计无瘤生存率分别为57%和33%,P<0.05;术后1年介入组和对照组的累计生存率分别为84%和55%,术后2年介入组和
对照组的累计生存率分别为63%和34%,P<0.05。结论在肝移植前行肝动脉介入栓塞化疗可以显著改善HCC患者术后的肝
功能和免疫功能,提高其无瘤生存率和术后生存率,具有临床应用价值。

Abstract: Objective To analyze the long-term therapeutic effects of transcatheter arterial chemoembolization (TACE) before
liver transplantation. Methods Forty-six patients with hepatocellular carcinoma (HCC) undergoing liver transplantation in our
department between November, 2009 and November, 2011 were analyzed. Of these patients, 24 received TACE before the
surgery while the other 22 did not. We compared the liver graft function (ALT and AST levels), immune function (CD3, CD4,
CD8, CD4/CD8, NK cells, activated T cells), cumulative survival rate and disease-free survival rate between the two groups at 1
year and 2 years after the operation. Results The patients receiving preoperative TACE showed significantly better liver
functions and immune function than those who did not receive TACE (P<0.01 and 0.05). The cumulative disease-free survival
rate in the two groups were 72% and 46% at 1 year, and were 57% and 33% at two years, respectively (P<0.05); the cumulative
survival rate in the two groups were 84% and 55% at 1 year, and 63% and 34% at two years, respectively (P<0.05). Conclusion
TACE prior to liver transplantation can significantly improve the postoperative liver function, immune function, disease-free
survival and cumulative survival rates in patients with HCC.