摘要目的 探讨载药微球化疗栓塞治疗肝癌患者肝移植等待期间的应用价值.方法 回顾分析2016年1月至2018年1月天津市第一中心医院肝癌患者肝移植等待期间接受载药微球化疗栓塞治疗的23例患者资料,记录并发症情况.介入治疗后4周行影像学检查,根据修订的实体肿瘤疗效评价标准(m-RECIST)评价肿瘤反应率.对接受肝移植的患者,记录病理情况,随访肝癌复发情况.结果 23例患者接受载药微球化疗栓塞的技术成功率为100％.其中1例接受了2次载药微球化疗栓塞治疗,其他22例均接受了1次.无严重并发症发生.18例(78.3％,18/23)患者在介入治疗后有栓塞后综合征表现,主要为发热和疼痛.术后4周影像学检查,完全缓解率为47.8％ (11/23),部分缓解率30.4％(7/23),疾病稳定率21.7％(5/23).23例患者均未被移出移植等待名单.其中15例已接受肝移植手术,病理结果显示肿瘤完全坏死率为53.3％(8/15),肿瘤坏死率＜50％的患者有4例,平均肿瘤坏死率为75.0％.15例肝移植患者术后随访无肿瘤复发.结论 载药微球化疗栓塞在肝癌肝移植等待期间应用安全有效,但由于载药微球在国内应用时间较短,仍需进一步研究.

abstractsObjective To evaluate the value of DEB-TACE before liver transplantation for hepatocellular carcinoma patients.Methods From Jan.2016 to Jan.2018,23 patients received DEB-TACE before liver transplantation for hepatocellular carcinoma were induced.Complications evaluation was followed up after interventional therapy.4 weeks after the intervention,the imaging examination was performed to examine the tumor response rate depond on mRECIST,the pathological conditions and tumor free survival were studied in the patients who received liver transplantation.Results The achievement ration of operation was 100％ in 23 patients.23 patients received 24 times successfully,1 patient received DEB-TACE twice,and the remaining 22 patients received DEB-TACE once.No serious complications occurred.Eighteen patients (78.3％,18/23) had postembolic syndrome after interventional therapy,mainly fever and pain.Four weeks after DEB-TACE,the complete response rate was 47.8％ (11/23),partial response rate was 30.4％ (7/23),disease stability rate was 21.7％ (5/23).All the 23 patients were included in the waiting list for transplantation.Among them,15 cases received liver transplantation.Pathological results showed that the total necrosis rate was 53.3％ (8/15),and the tumour necrosis rate in 4 of them was less than 50％.The average tumour necrosis rate of the neoplasm was 75.0％.The 15 patients who received liver transplantation were alive with no tumor recurrence.Conclusion DEB-TACE is a safe and effective treatment for patients suffered from hepatocellular carcinoma in waiting for liver transplantation.However,due to the short time of DEBs in China,further research is needed.