摘要
目的探究载药微球(DEB)-经动脉化疗栓塞(TACE)术中“血管湖”(VL)现象发生的机制与其对预后的影响。方法搜集2016年9月至2019年9月首次行DEB-TACE治疗的286例肝细胞癌患者,根据术中是否出现VL现象,分为VL组(n=49)和non-VL组(n=237)。对比两组患者VL现象发生率,并通过Logistic回归分析影响VL现象发生率的因素。记录两组患者术后4~6周采用CT或MR评估预后,比较两组患者的总生存期(OS)和无进展生存期(PFS)。对比两组在术后的不良反应(发热、恶心呕吐、疼痛)程度。结果VL现象患者的发生率为17.1%(49/286);VL组术后血红蛋白无异常;Logistic回归分析结果显示:肿瘤直径越大(OR 2.417,95%CI:1.303~4.482)、存在假包膜(OR 6.117,95%CI:3.205~11.675)及小粒径载药微球(OR 3.124,95%CI:1.373~7.105)对VL现象的发生率影响较大;两组患者预后评估存在统计学差异(P<0.001);VL组的中位OS为21个月,non-VL组的中位OS为17个月(P<0.001)。VL组的中位PFS为8个月,non-VL组的中位PFS为5个月两组患者术后各项不良反应无统计学差异(P<0.001)。结论VL现象的发生与较大的肿瘤直径、存在假包膜以及小粒径载药微球有关系,未增加术后患者的不良反应并预示着更好的疗效。
Objective To explore the mechanism of“vascular Lake”(VL)phenomenon in CalliSpheres drug-eluting bead transcatheter arterial chemoembolization treating unresectable Hepatocellular Carcinoma and its influence on prognosis.Methods 286 patients with HCC who were first treated with DEB-TACE in our department from September 2016 to September 2019,and were divided into VL group(n=49)and non VL group(n=237)according to whether there was VL phenomenon during operation.The incidence of VL was compared between the two groups,and the factors influencing the incidence of VL were analyzed by Logistic regression.The CT or MR findings of the two groups were recorded 4 weeks after operation to evaluate the prognosis.We compared overall survival(OS)and progress free survival(PFS).The adverse reactions(fever,nausea and vomiting,pain)were compared between the two groups.Results The incidence of VL phenomenon was 17.1%(49/286).The results of logistic regression analysis showed that whether the tumor diameter was,whether the tumor had a pseudocapsule had a significant impact on the occurrence of VL phenomenon;there was a statistical difference in the prognosis evaluation between the two groups(P<0.001);The median OS was 21 months in the VL group and 17 months in the non-VL group(P<0.001).The median PFS was 8 months in the VL group and 5 months in the non-VL group(n<0.001).There was no statistical difference in adverse reactions between the two groups.Conclusion The occurrence of VL phenomenon is related to the size of the tumor and whether there is pseudocapsule in the tumor.It does not increase the adverse reactions of the patient after operation and indicates a better curative effect.
作者
王满周
段旭华
韩新巍
任建庄
陈鹏飞
张萌帆
李浩
许文泽
WANG Manzhou;DUAN Xuhua;HAN Xinwei(Department of Radiology,The First Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan Province 450052,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第6期1132-1138,共7页
Journal of Clinical Radiology
关键词
原发性肝癌
经动脉化疗栓塞
载药微球
血管湖
Primary hepatocellular carcinoma
Trans arterial chemoembolization
Drug-eluting beads
Vascular lake
