世界范围内的肝癌肝移植：台湾经验。

Liver transplantation for hepatocellular carcinoma in the world: the Taiwan experience.

机构信息

Liver Transplant Program, and Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, Taiwan.

出版信息

J Hepatobiliary Pancreat Sci. 2010 Sep;17(5):555-8. doi: 10.1007/s00534-009-0166-7. Epub 2009 Sep 18.

DOI:10.1007/s00534-009-0166-7

PMID:19760360

Abstract

Liver transplantation (LT) has been regarded as "potentially curative" in a cirrhotic patient with hepatocellular carcinoma (HCC) because it removes the cancer and eradicates the cirrhosis. In Taiwan, HCC ranks first among the leading causes of cancer mortality in males and 4th in females. The most common causes are chronic hepatitis B virus-related cirrhosis, hepatitis C virus-related cirrhosis, and combined hepatitis B and C virus-related cirrhosis. The aggregate lifetime cost of hepatitis and HCC constitutes a significant burden on the Taiwanese health-care system. The reported overall (living-donor LT and deceased donor LT) 1- and 3-year survival rates for HCC after LT in Taiwan ranged from 86 to 98% and 61 to 96%, respectively. Microscopic vascular invasion did not influence the outcome of patients, but high alpha-fetoprotein levels >200 ng/ml may be a risk factor for HCC recurrence after transplant.

摘要

肝移植（LT）被认为是肝硬化伴肝细胞癌（HCC）患者的“潜在治愈性”方法，因为它不仅可以切除肿瘤，还可以消除肝硬化。在台湾，肝癌在男性癌症死亡原因中排名第一，在女性中排名第四。最常见的原因是慢性乙型肝炎病毒相关肝硬化、丙型肝炎病毒相关肝硬化和乙型肝炎病毒与丙型肝炎病毒联合相关肝硬化。肝炎和 HCC 的总终身费用给台湾的医疗保健系统带来了巨大的负担。台湾报道的 LT 后 HCC 的总生存率（活体供体 LT 和已故供体 LT）分别为 86%至 98%和 61%至 96%。微血管侵犯并不影响患者的预后，但甲胎蛋白水平>200ng/ml 可能是移植后 HCC 复发的一个危险因素。