Hung Tsung-Hsing, Tsai Chen-Chi, Lin Chung-Chi, Lee Hsing-Feng, Chu Chi-Jen, Lin Han-Chieh
Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan, Republic of China.
School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.
Hepatol Int. 2013 Jun;7(2):676-82. doi: 10.1007/s12072-012-9392-1. Epub 2012 Jul 27.
Diffuse infiltrative hepatocellular carcinoma (D-HCC) is an incurable disease with short survival time. Transarterial chemoembolization (TACE) was often used to alleviate patient's symptoms and reduce tumor burden. However, it remains unknown if the TACE benefits the survival of D-HCC patients.
A hospital-based retrospective study was conducted at a large referral hospital in Taiwan for a 9-year period (2000-2008).
Of the 150 D-HCC patients, 106 patients were related to hepatitis B virus (HBV), 17 to hepatitis C virus (HCV), 3 to both HBV and HCV, and 24 not to HBV or HCV. Multivariate Cox regression analysis showed treatment strategy, serum alpha-fetoprotein level, model for end-stage liver disease (MELD) score, serum gamma glutamyl transferase, and serum lactic acid dehydrogenase were associated with survival time. Compared to supportive treatment, the adjusted hazard ratios of transarterial chemoembolization (TACE) and chemotherapy including oral or systemic chemotherapy were 0.383 (p < 0.001) and 0.711 (p = 0.289), respectively.
TACE is a preferred therapy for D-HCC patients.
弥漫性浸润性肝细胞癌（D-HCC）是一种无法治愈且生存时间短的疾病。经动脉化疗栓塞术（TACE）常用于缓解患者症状并减轻肿瘤负荷。然而，TACE是否能使D-HCC患者获益于生存仍不清楚。
在台湾一家大型转诊医院进行了一项为期9年（2000 - 2008年）的基于医院的回顾性研究。
150例D-HCC患者中，106例与乙型肝炎病毒（HBV）相关，17例与丙型肝炎病毒（HCV）相关，3例与HBV和HCV均相关，24例与HBV或HCV均无关。多因素Cox回归分析显示，治疗策略、血清甲胎蛋白水平、终末期肝病模型（MELD）评分、血清γ-谷氨酰转移酶和血清乳酸脱氢酶与生存时间相关。与支持性治疗相比，经动脉化疗栓塞术（TACE）和包括口服或全身化疗在内的化疗的校正风险比分别为0.383（p < 0.001）和0.711（p = 0.289）。
TACE是D-HCC患者的首选治疗方法。
