[1]张玥,王涛,岳振东,等.TIPS联合125I粒子植入治疗肝癌门脉主干癌栓及合并症的效果[J].介入放射学杂志,2020,29(01):89-95.
　ZHANG Yue,WANG Tao,YUE Zhendong,et al.Clinical efficacy of TIPSS combined with 125I seeds implantation for HCC associated with main portal vein tumor thrombus and complications[J].journal interventional radiology,2020,29(01):89-95.
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TIPS联合125I粒子植入治疗肝癌门脉主干癌栓及合并症的效果()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年01
页码:
89-95
栏目:
临床研究
出版日期:
2020-02-10

文章信息/Info

Title:
Clinical efficacy of TIPSS combined with 125I seeds implantation for HCC associated with main portal vein tumor thrombus and complications
作者:
张玥; 王涛; 岳振东; 赵洪伟; 王磊; 范振华; 何福亮; 吴一凡; 刘福全
Author(s):
ZHANG Yue;  WANG Tao;  YUE Zhendong;  ZHAO Hongwei;  WANG Lei;  FAN Zhenhua;  HE Fuliang;  WU Yifan;  LIU Fuquan.
Department of Interventional Therapy, Ninth School of Clinical Medicine of Peking University, Beijing 100038, China
关键词:
【关键词】　肝癌; 门静脉; 癌栓; 经颈静脉门腔静脉分流术; 碘放射性核素
文献标志码:
A
摘要:
【摘要】　目的?分析TIPS联合125I粒子植入术治疗肝癌门静脉主干癌栓的临床疗效。方法?收集2011年1月至2016年3月收治的肝癌门静脉主干癌栓合并门静脉高压的患者102例，分为TIPS联合125I放射粒子植入术（研究组）57例，单纯应用TIPS（对照组）45例。比较两组在分流前后的门静脉压力，治疗效果（标准缓解率、总有效率），预后情况（累积生存率、中位生存期、分流道累积再狭窄率、症状复发率）等。 结果?①术中两组在分流后的门静脉压力均低于分流前，差异有统计学意义（P＜0.001）；②研究组的标准缓解率高于对照组（96.5% 比 26.7%），总有效率亦高于对照组（100%比35.6%），差异均有统计学意义（χ2=65.045、51.326，P＜0.001）；③术后6个月，研究组的分流道累积再狭窄率为8.8%（5/57），低于对照组的24.4%（11/45）；症状复发率为10.5%（6/57），亦低于对照组的26.7%（12/45），差异均有统计学意义（P＜0.01）；④研究组的中位生存期为11.8个月，高于对照组的7.3个月，差异有统计学意义。结论?TIPS联合125I粒子植入术治疗肝癌门静脉主干癌栓及其合并症效果好、安全性高，在很大程度上延长了患者生存期。

参考文献/References:

1 Takizawa D, Kakizaki S, Sohara N, et al. Hepatocellular carcinoma with portal vein tumor thrombosis: clinical characteristics, prognosis, and patient survival analysisJ. Dig Dis Sci, 2007, 52:3290-3295.
2 Yamamoto Y, Ikoma H, Morimura R, et al. Post-hepatectomy survival in advanced hepatocellular carcinoma with portal vein tumor thrombosisJ. World J Gastroenterol, 2015, 21:246-253.
3 王?龙， 张?勇， 王亚运， 等.125I粒子联合经导管动脉化疗栓塞治疗肝细胞肝癌伴门静脉癌栓临床有效性与安全性meta分析J. 介入放射学杂志, 2018, 27:31-38.
4 Shi J, Lai ECH, Li N, et al. A new classification for hepatocellular carcinoma with portal vein tumor thrombusJ. J Hepatobiliary Pancreat Sci, 2011, 18:74-80.
5 Cauchy F, Fuks D, Belghiti J. HCC: current surgical treatment conceptsJ. Langenbecks Arch Surg, 2012, 397:681-695.
6 中国抗癌协会肝癌专业委员会. 原发性肝癌诊断标准J. 中华肝脏病杂志, 2000, 8: 135.
7 Fagiuoli S, Bruno R, Debernardi Venon W, et al. Consensus conference on TIPS management: techniques, indications, contraindicationsJ. Dig Liver Dis, 2017, 49: 121-137.
8 Lencioni R， Llovet JM. Modified RECIST（mRECIST） assessment for hepatocellular carcinomaJ. Semin Liver Dis, 2010, 30:52-60.
9 Bettinger D， Knüppel, E, Euringer W， et al. Efficacy and safety of transjugular intrahepatic portosystemic shunt （TIPSS） in 40 patients with hepatocellular carcinomaJ. Aliment Pharmacol Ther, 2015, 41:126-136.
10 Liu L, Zhao Y, Qi X, et al. Transjugular intrahepatic portosystemic shunt for symptomatic portal hypertension in hepatocellular carcinoma with portal vein tumor thrombosisJ. Hepatol Res, 2014, 44:621-630.
11 Qiu B, Li K, Dong X, et al. Transjugular intrahepatic portosystemic shunt for portal hypertension in hepatocellular carcinoma with portal vein tumor thrombusJ. Cardiovasc Intervent Radiol, 2017, 40:1372-1382.
12 Luo J, Yan Z, Liu Q, et al. Endovascular placement of iodine-125 seed strand and stent combined with chemoembolization for treatment of hepatocellular carcinoma with tumor thrombus in main portal veinJ. J Vasc Interv Radiol, 2011, 22:479-489.
13 Mazzaferro V, Sposito C, Bhoori S, et al. Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: a phase 2 studyJ. Hepatology, 2013, 57:1826-1837.
14 Yu T, Luo J, Yan Z. HCC with main portal vein tumor thrombus treated by stent placement and TACE combined with endovascular brachytherapy or three dimensional conformal radiotherapyJ. Brachytherapy, 2016, 15:S84-S85.


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备注/Memo

备注/Memo:
（收稿日期：2019-01-31）
（本文编辑：俞瑞纲）
更新日期/Last Update: 2020-02-08