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目的：探讨小肝癌经导管肝动脉注射碘油抗癌药栓塞化疗（ＴＯＣＥ）的疗效及影响预后的因素。材料与方法：小肝癌３０例，全部接受ＴＯＣＥ治疗后随访３～５年以上，其中２４例单纯行ＴＯＣＥ治疗，作为Ａ组；另６例ＴＯＣＥ后４～６周行手术切除，作为Ｂ组。两组分别统计生存率和死亡原因。结果：Ａ组１、３、５年生存率分别为７９．３％、３７．５％和２２．２％；Ｂ组则为１００％、６６．７％和２５％。生存≥３年的患者主要死于肝内肿瘤复发与肝外转移，生存＜３年的患者主要死于上消化道出血与肝功能衰竭。结论：ＴＯＣＥ治疗小肝癌疗效尚不及其他方法，必须以节段性肝动脉栓塞化疗（ＳＴＯＣＥ）取而代之，最好与手术切除或经皮无水乙醇注射（ＰＥＩ）联合应用。影响小肝癌ＴＯＣＥ近期疗效的主要因素是肝硬化所致的上消化道出血和肝功能衰竭，而影响其远期疗效的主要因素则为肝内肿瘤复发与肝外转移。
Objective: To investigate the effect of transcatheter hepatic artery injection of lipiodol anti-cancer chemotherapy (TOCE) on small hepatocellular carcinoma and its prognostic factors. Materials and Methods: 30 cases of small hepatocellular carcinoma were followed up for more than 3 to 5 years after being treated with TOCE. 24 cases were treated with TOCE alone as group A; 6 cases were treated with TOCE 4 to 6 weeks after resection as group B. The two groups were statistically analyzed for survival rate and cause of death. Results: The 1, 3, and 5-year survival rates in group A were 79.3%, 37.5%, and 22.2%, respectively; in group B, 100%, 66.7%, and 25%. Patients with ≥3 years of survival mainly died of intrahepatic tumor recurrence and extrahepatic metastasis. Patients who survived for <3 years mainly died of upper gastrointestinal bleeding and hepatic failure. Conclusion: The efficacy of TOCE in the treatment of small hepatocellular carcinoma is inferior to other methods. It must be replaced by segmental transcatheter arterial chemoembolization (S-TOCE). It is best combined with surgical resection or percutaneous ethanol injection (PEI). The main factors influencing the short-term efficacy of TOCE in small hepatocellular carcinoma are upper gastrointestinal bleeding and hepatic failure caused by cirrhosis. The main factors influencing its long-term efficacy are intrahepatic tumor recurrence and extrahepatic metastasis.