The effect of preoperative transcatheter arterial chemoembolization on prognosis of patients with hepatocellular carcinoma in differentsizes
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 12
- DOI:
- 10.3760/j.issn:1005-1201.2001.12.005
- Key Word:
- 癌,肝细胞;化学栓塞,治疗性;病理学;基因表达;流式细胞术;免疫组织化学;对比研究
Abstract： 目的从整体、细胞和基因分子水平研究经导管动脉化疗栓塞(transcatheter arterial chemoembolization, TACE)对不同大小肝细胞癌(hepatocellular carcinoma, HCC)预后的影响.方法经手术病理证实的肝细胞癌110例,TACE后Ⅱ期手术切除53例(A组),单纯手术57例(B组),肿瘤直径≤8 cm者被分为A1组(18例)和B1组(30例);>8 cm者被分为A2组(35例)和B2组(27例).用流式细胞术检测凋亡率(apoptotic rate, AR)、S期细胞比率(S-phase fraction, SPF)和增殖指数(proliferative index, PI),用免疫组化检测各标本ras癌基因的表达蛋白p21、P-糖蛋白( P-glycoprotein, Pgp)、上皮型钙黏蛋白(epithelial cadherin, ECD)和nm23癌基因的表达蛋白二磷酸核苷激酶( nucleoside diphosphate kinase, ndpk).回顾分析各组这些标志物改变、肿瘤坏死、包膜形成情况,并统计肿瘤体积、转移率及累计生存率.结果肿瘤直径≤8 cm和>8 cm者,术前TACE均可引起肿瘤坏死、诱导凋亡、肿瘤包膜形成、体积缩小、转移潜能下降,1、2、3年累计生存率,A1组分别为94.4%、66.7%和44.4%,B1组分别为 90.0%、63.3%和40.0%(P>0.05);A2组分别为88.6%、60.0%和51.4%,B2组分别为59.3%、48.1% 和25.9%(P<0.05).结论术前TACE对所有肝细胞癌,尤其肿瘤直径>8 cm者安全有效.
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