Guan Yong-Song, Liu Yuan
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Hepatobiliary Pancreat Dis Int. 2006 Nov;5(4):495-500.
Hepatocellular carcinoma (HCC) is one of the most frequent primary malignant tumors in the world. Hepatic resection and liver transplantation are considered optimal for potential treatment of HCC. However, only 20% of HCCs can be surgically treated. And most of surgically-noneligible patients have to receive interventional managements including local ablation and transarterial chemoembolization (TACE). In this paper, we review the interventional treatments of HCC.
A literature search of PubMed database was conducted and research articles were reviewed.
Percutaneous ethanol injection (PEI) is usually applied to small HCC for a complete necrosis. Radiofrequency ablation, an alternative to PEI, also causes tumor necrosis and needs fewer times of ablation. Other methods such as acetic acid injection, laser, microwave, etc have enriched local ablation for HCC. High intensity focus ultrasound (HIFU) is thought to be promising. TACE, another common modality, can improve the survival rate of patients with HCC. The newly developed embolic agents and adjuvant rAd-p53 gene therapy are well reported.
Surgically-noneligible HCC can be treated with interventional procedures. Each method has its advantages and disadvantages. However, it is still pressing to develop ablative methods as well as new embolic agents for a better prognosis of HCC.
肝细胞癌(HCC)是全球最常见的原发性恶性肿瘤之一。肝切除和肝移植被认为是HCC潜在治疗的最佳方法。然而,只有20%的HCC患者能够接受手术治疗。大多数无法进行手术的患者不得不接受包括局部消融和经动脉化疗栓塞(TACE)在内的介入治疗。在本文中,我们综述了HCC的介入治疗。
对PubMed数据库进行文献检索并对研究文章进行综述。
经皮乙醇注射(PEI)通常用于小肝癌以实现完全坏死。射频消融作为PEI的替代方法,也可导致肿瘤坏死且所需消融次数较少。其他方法如醋酸注射、激光、微波等丰富了HCC的局部消融治疗。高强度聚焦超声(HIFU)被认为具有前景。TACE是另一种常见的治疗方式,可提高HCC患者的生存率。新开发的栓塞剂和辅助rAd-p53基因治疗有大量报道。
无法进行手术的HCC患者可通过介入治疗。每种方法都有其优缺点。然而,为了改善HCC的预后,开发消融方法以及新型栓塞剂仍然十分迫切。