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载药微球化疗栓塞后转移性肝肿瘤患者发生肝脓肿。

Liver abscess after drug-eluting bead chemoembolization in patients with metastatic hepatic tumors.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.

出版信息

Br J Radiol. 2022 Jan 1;95(1129):20211056. doi: 10.1259/bjr.20211056. Epub 2021 Nov 29.

Abstract

OBJECTIVE

To investigate the incidence and risk factors for liver abscess formation after treatment with drug-eluting bead chemoembolization (DEB-TACE) in patients with metastatic hepatic tumors (MHT).

METHODS

The current study is a retrospective analysis of the clinical data of 137 patients with metastatic hepatic tumors who received DEB-TACE treatment in our institute (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) between June 2015 and September 2020. Patients were evaluated for the presence or absence of post-DEB-TACE liver abscess. Univariate and multivariate analyses were used to identify risk factors for liver abscess formation.

RESULTS

The incidence of liver abscess formation after the DEB-TACE procedure was 8.76% per patient and 5.53% per procedure. Univariate analysis showed that larger maximum tumor diameter ( = 0.004), Grade 1 artery occlusion ( < 0.001) and systemic chemotherapy within 3 months before the DEB-TACE procedure ( < 0.001) were all associated with liver abscess formation. However, only systemic chemotherapy within 3 months before the DEB-TACE procedure (OR 5.49; 95% CI 0.34-13.54; < 0.001) was identified by multivariate analysis to be an independent risk factor.

CONCLUSIONS

Tumor size, Grade 1 artery occlusion and recent systemic chemotherapy may all be associated with increased risk of liver abscess formation following DEB-TACE treatment in patients with metastatic hepatic tumors.

ADVANCES IN KNOWLEDGE

Identification of risk factors for liver abscess formation following DEB-TACE in patients with MHT. These findings suggest the need for caution and consideration of the aforementioned risk factors on the part of interventional radiologists when designing DEB-TACE strategies and performing post-procedure patient management.

摘要

目的

探讨药物洗脱微球化疗栓塞(DEB-TACE)治疗转移性肝肿瘤(MHT)患者后肝脓肿形成的发生率及相关危险因素。

方法

本研究回顾性分析了 2015 年 6 月至 2020 年 9 月在华中科技大学同济医学院附属协和医院接受 DEB-TACE 治疗的 137 例转移性肝肿瘤患者的临床资料。评估患者 DEB-TACE 后是否存在肝脓肿。采用单因素和多因素分析确定肝脓肿形成的危险因素。

结果

DEB-TACE 术后肝脓肿的发生率为患者 8.76%/例和术式 5.53%/例。单因素分析显示,肿瘤最大直径较大( = 0.004)、1 级动脉闭塞( < 0.001)和 DEB-TACE 术前 3 个月内全身化疗( < 0.001)与肝脓肿形成有关。然而,多因素分析仅发现 DEB-TACE 术前 3 个月内全身化疗(OR 5.49;95%CI 0.34-13.54; < 0.001)是肝脓肿形成的独立危险因素。

结论

肿瘤大小、1 级动脉闭塞和近期全身化疗均可能与 MHT 患者 DEB-TACE 治疗后肝脓肿形成风险增加有关。

知识进展

确定 MHT 患者 DEB-TACE 后肝脓肿形成的危险因素。这些发现提示介入放射科医生在设计 DEB-TACE 策略和进行术后患者管理时需要谨慎,并考虑上述危险因素。

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