Farinati F, De Maria N, Fornasiero A, Salvagnini M, Fagiuoli S, Chiaramonte M, Naccarato R
Divisione di Gastroenterologia R. Farini, Istituto di Medicina Interna, Policlinico Universitario, Padova, Italy.
Dig Dis Sci. 1992 May;37(5):659-62. doi: 10.1007/BF01296419.
Clinical and experimental evidence indicates that estrogens are involved in the control of hepatocyte proliferation both in normal and in neoplastic conditions. Thirty-two cirrhotic patients with unresectable or otherwise untreatable hepatocellular carcinoma were allocated to receive either tamoxifen (30 mg/day) or no treatment. The patients in the two groups were matched for age, male/female ratio, Child-Pugh class, approximate tumor volume (US and CT scan), and etiology of the underlying cirrhosis. Survival of the tamoxifen-treated patients (life-table, Wilcoxon-Breslow) was significantly prolonged (P = 0.0038), with 35% (vs 0%) survival at 12 months. No difference was observed between males and females or between alcoholic and nonalcoholic cirrhosis. In 40% of tamoxifen-treated patients, the levels of alpha-fetoprotein declined. In conclusion, the antiestrogen tamoxifen appears to be effective in the palliative treatment of hepatocellular carcinoma. An initial decline in alpha-fetoprotein levels may represent an early favorable prognostic sign.
临床和实验证据表明，雌激素在正常和肿瘤状态下均参与肝细胞增殖的调控。32例患有不可切除或其他无法治疗的肝细胞癌的肝硬化患者被分配接受他莫昔芬（30毫克/天）治疗或不接受治疗。两组患者在年龄、男女比例、Child-Pugh分级、大致肿瘤体积（超声和CT扫描）以及潜在肝硬化病因方面进行了匹配。接受他莫昔芬治疗的患者的生存期（生命表，Wilcoxon-Breslow法）显著延长（P = 0.0038），12个月时生存率为35%（相比之下未治疗组为0%）。男性和女性之间或酒精性肝硬化和非酒精性肝硬化之间未观察到差异。在40%接受他莫昔芬治疗的患者中，甲胎蛋白水平下降。总之，抗雌激素药物他莫昔芬似乎对肝细胞癌的姑息治疗有效。甲胎蛋白水平的初始下降可能代表早期良好的预后迹象。
