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肝硬化对原发性肝癌患者右肝切除术前门静脉栓塞的影响。

Effects of liver cirrhosis on portal vein embolization prior to right hepatectomy in patients with primary liver cancer.

作者信息

Sun Jun-Hui, Zhang Yue-Lin, Nie Chun-Hui, Li Ju, Zhou Tan-Yang, Zhou Guan-Hui, Zhu Tong-Yin, Chen Li-Ming, Wang Wei-Lin, Zheng Shu-Sen

机构信息

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.

出版信息

Oncol Lett. 2018 Feb;15(2):1411-1416. doi: 10.3892/ol.2017.7530. Epub 2017 Dec 5.

Abstract

Preoperative portal vein embolization (PVE) induces compensatory hyperplasia of the future liver remnants (FLR), thus increasing resectability in the non-cirrhotic patients with primary liver cancer (PLC). However, it is unclear if it is similar in patients with liver cirrhosis. Therefore, the present study investigated the PVE value prior to liver resection in patients with PLC, and the liver cirrhotic effects on the compensatory hypertrophy of FLRs following PVE. In the present study, 21 patients with PLC who successfully underwent hepatic resection subsequent to PVE, were retrospectively examined. The patients were divided into a non-cirrhosis group and a cirrhosis group according to the absence or presence of cirrhosis, respectively. The FLR volume between the two groups of patients was compared. There was a significant difference in the FLR volume for all patients prior to, and 4-6 weeks following, PVE (P<0.001). PVE induced significant compensatory hypertrophy in the FLRs whether in the non-cirrhosis group (P=0.002) or cirrhosis group (P<0.001). However, no significant difference was identified between the two groups with respect to FLR volume enlargement 4-6 weeks following PVE (P=0.373). In conclusion, PVE prior to hepatectomy may promote FLR compensatory hypertrophy and an increase in the resectability of PLC tumors. No significant effects of liver cirrhosis were identified on liver lobe hyperplasia following PVE.

摘要

术前门静脉栓塞术(PVE)可诱导未来肝残余(FLR)代偿性增生,从而提高非肝硬化原发性肝癌(PLC)患者的可切除性。然而,对于肝硬化患者是否也有类似情况尚不清楚。因此,本研究探讨了PLC患者肝切除术前PVE的价值,以及肝硬化对PVE后FLR代偿性肥大的影响。在本研究中,对21例成功接受PVE后肝切除术的PLC患者进行了回顾性检查。根据是否存在肝硬化,将患者分别分为非肝硬化组和肝硬化组。比较两组患者的FLR体积。所有患者在PVE前和PVE后4 - 6周的FLR体积存在显著差异(P<0.001)。无论是在非肝硬化组(P = 0.002)还是肝硬化组(P<0.001),PVE均诱导FLR出现显著的代偿性肥大。然而,PVE后4 - 6周,两组之间在FLR体积增大方面未发现显著差异(P = 0.373)。总之,肝切除术前的PVE可能促进FLR代偿性肥大并提高PLC肿瘤的可切除性。未发现肝硬化对PVE后肝叶增生有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b508/5777121/3127078c27b5/ol-15-02-1411-g00.jpg

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