结直肠癌肝转移患者的动静脉分流
Arteriovenous shunting in patients with colorectal liver metastases.
作者信息
Goldberg J A, Thomson J A, McCurrach G, Anderson J H, Willmott N, Bessent R G, McKillop J H, McArdle C S
机构信息
University Department of Surgery, Royal Infirmary, Glasgow, UK.
出版信息
Br J Cancer. 1991 Mar;63(3):466-8. doi: 10.1038/bjc.1991.109.
The outlook for patients with colorectal liver metastases is poor. Microspheres have been combined with cytotoxics and administered via the hepatic artery in an attempt to improve tumour drug exposure within the liver. However, it has been suggested that arteriovenous connections might occur in association with intrahepatic tumours causing loss of regional advantage, and that the administration of microspheres further exacerbates arteriovenous shunting. In seven patients with colorectal liver metastases, base-line shunting was measured using a tracer quantity of radio-labelled albumin microspheres. The shunted fraction of a 'therapeutic quantity' of microspheres was subsequently measured in the same group of patients using albumin microspheres carrying a different radio-label. Base-line shunt for 0.5 x 10(6) microspheres was found to be 2.2 +/- 1.8% (mean +/- s.d.); the percentage shunt of a therapeutic quantity (40-80 x 10(6)) of microspheres was 3.0 +/- 0.8%. We conclude that arteriovenous shunting in patients with colorectal liver metastases is minimal, and is not significantly increased by the administration of therapeutic quantity of microspheres during regional chemotherapy.
结直肠癌肝转移患者的预后较差。微球已与细胞毒素联合，并通过肝动脉给药，试图提高肝脏内肿瘤的药物暴露量。然而，有人提出肝内肿瘤可能会伴有动静脉分流，导致局部优势丧失，并且微球的给药会进一步加剧动静脉分流。在7例结直肠癌肝转移患者中，使用微量放射性标记白蛋白微球测量基线分流情况。随后，在同一组患者中，使用携带不同放射性标记的白蛋白微球测量“治疗剂量”微球的分流部分。发现0.5×10⁶个微球的基线分流为2.2±1.8%（平均值±标准差）；治疗剂量（40 - 80×10⁶）微球的分流百分比为3.0±0.8%。我们得出结论，结直肠癌肝转移患者的动静脉分流极少，并且在区域化疗期间给予治疗剂量的微球不会使其显著增加。
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