Elias D, De Baere T, Roche A, Leclere J, Lasser P
Department of Surgical Oncology and Interventional Radiology, Institut Gustave Roussy, Villejuif, France.
Br J Surg. 1999 Jun;86(6):784-8. doi: 10.1046/j.1365-2168.1999.01154.x.
The relative growth rates of human liver metastases are not known. The aim of this study was to determine in humans the growth rate of liver parenchyma during regeneration and the growth rate of liver metastases during the same process.
Among 556 patients hepatectomized for a malignant lesion, 48 underwent preoperative selective right portal vein embolization to induce hypertrophy of the left lobe. Five cases were selected because a liver metastasis was present inside the regenerating left lobe. The volumes of the liver metastasis and left lobe were measured with a three-dimensional technique on pre-embolization and postembolization computed tomography (CT) or CT arterial portography. The median interval between the two measurements was 34 (range 28-40) days.
An increase occurred in the volume of the liver metastasis and the left lobe in the four patients with functionally intact liver parenchyma, but not in the patient with an impaired parenchyma. The volumetric increase of the normal liver varied from 59 to 127 per cent, compared with 60 to 970 per cent for the liver metastases. The ratio between the growth rate of the left lobe and the liver metastasis varied from 1.0 to 15.6. The growth rates of two metastases in the left lobe of a single patient were different.
In functionally intact liver parenchyma, during hepatic regeneration or hypertrophy, the growth rate of metastases is more rapid that that of the liver parenchyma. However, a wide variation in growth rate is observed between patients and between metastases.
人类肝转移瘤的相对生长速率尚不清楚。本研究的目的是确定人类肝脏实质在再生过程中的生长速率以及同一过程中肝转移瘤的生长速率。
在556例因恶性病变接受肝切除术的患者中，48例接受了术前选择性右门静脉栓塞以诱导左叶肥大。选择5例是因为在再生的左叶内存在肝转移瘤。在栓塞前和栓塞后的计算机断层扫描（CT）或CT动脉门静脉造影上，采用三维技术测量肝转移瘤和左叶的体积。两次测量之间的中位间隔为34天（范围28 - 40天）。
4例肝实质功能完好的患者，其肝转移瘤和左叶体积均增大，但肝实质受损的患者未出现这种情况。正常肝脏的体积增加幅度为59%至127%，而肝转移瘤的增加幅度为60%至970%。左叶与肝转移瘤的生长速率之比在1.0至15.6之间。同一患者左叶内两个转移瘤的生长速率不同。
在肝实质功能完好的情况下，在肝脏再生或肥大过程中，转移瘤的生长速率比肝实质的生长速率更快。然而，患者之间以及转移瘤之间的生长速率存在很大差异。
