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目的探讨临床治疗原发性肝癌合并门静脉癌栓的有效方法及疗效。方法对我院2008年1月至2010年1月期间收治的29例原发性肝癌合并门静脉癌栓患者的临床资料进行回顾性分析,并按治疗方法的不同将患者分为经动脉导管栓塞术(TAE)治疗组和TAE+门静脉灌注化疗治疗组,比较2组患者的治疗效果。结果TAE治疗组治疗有效率、门静脉癌栓缩小率和AFP转阴率分别为43.75%、18.75%和37.50%,TAE+门静脉灌注治疗组分别为76.92%、61.54%和61.54%,2组比较后者优于前者(P<0.05)。TAE+门静脉灌注治疗组患者治疗后半年及1年生存率高于TAE治疗组(P<0.05)。TAE治疗组患者生存时间为4～18个月,中位生存期为8个月;TAE+门静脉灌注治疗组患者生存时间为5～18个月,中位生存期为11个月。结论TAE+门静脉灌注化疗是一种安全可行的治疗方法,可延长原发性肝癌合并门静脉癌栓患者的生存时间。
Objective To investigate the effective treatment and curative effect of clinical treatment of primary hepatocellular carcinoma with portal vein tumor thrombus. Methods The clinical data of 29 patients with primary hepatocellular carcinoma complicated with portal vein tumor thrombus admitted from January 2008 to January 2010 in our hospital were retrospectively analyzed. According to the different treatment methods, the patients were divided into two groups: transcatheter arterial embolization (TAE) treatment group and TAE + portal vein chemotherapy group, the treatment effect of two groups were compared. Results The effective rate of TAE treatment, the rate of suppressive rate of portal vein cancer and the rate of AFP negative conversion were 43.75%, 18.75% and 37.50%, respectively. The rates of TAE + portal vein infusion in treatment group were 76.92%, 61.54% and 61.54% Better than the former (P <0.05). The survival rates at 6 and 1 year after TAE + portal vein infusion in treatment group were higher than those in TAE treatment group (P <0.05). The survival time of TAE treatment group was 4 to 18 months, and the median survival time was 8 months. The survival time of TAE + portal vein infusion group was 5 to 18 months and the median survival time was 11 months. Conclusions TAE + portal vein chemotherapy is a safe and feasible method of treatment, which can prolong the survival of patients with primary hepatocellular carcinoma and portal vein tumor thrombus.