摘要原发性肝癌能够手术切除者占20%左右,近年由于经动脉化疗栓塞术(TACE)等局部介入治疗技术的发展,使不能切除的肝癌缩小后行二期切除逐渐成为一个鲜明特色,并取得满意疗效.目前,手术切除仍被认为是肝癌治疗首选,同时确立了"以手术为主综合治疗"的原则,以TACE为代表的微创介入技术是提高疗效的重要环节.本文旨在对TACE在不能切除肝癌治疗中的机制、作用与意义进行再认识,并对TACE后二期切除的时机与指征、手术方式的选择和影响二期切除预后的因素进行综述.

abstractsThe resection can be performed in about 20 percent of patients with primary hepatocellular carcinoma(PHC) in clinic. However, with the development of interventional treatment such as transcatheter arterial chemoembolization(TACE), better therapeutic effect has been achieved by two-stage resection such as TACE in patients with unresectable PHC. At present, surgical resection is still regarded as the first choice of PHC, and the principle of comprehensive therapeutic solutions around surgical operation has been established. The pretreatment of TACE is an important measure to improve the therapeutic effect in PHC.This paper discussed the mechanism, effect and value of TACE in pretreatment of unresectable PHC. The selection of operative opportunity, sign, and ways after TACE and the factors affecting prognosis of two-stage resection were also reviewed.