Yen F S, Wu J C, Kuo B I, Chiang J H, Chen T Z, Lee S D
Department of Medicine and Radiology, National Yang-Ming Medical College, Taiwan, Republic of China.
J Gastroenterol Hepatol. 1995 May-Jun;10(3):237-40. doi: 10.1111/j.1440-1746.1995.tb01086.x.
In order to evaluate the possible benefits of transcatheter arterial embolization (TAE) in hepatocellular carcinoma (HCC) patients with peripheral portal vein thrombosis, 96 consecutive HCC cases with peripheral portal vein thrombosis were analysed. Of them, 35 cases received TAE and 61 cases did not. Most (77.8%) of the TAE-treated cases showed decreased alpha-fetoprotein (AFP) levels after treatment, but 57.1% of them suffered another rise in AFP levels and subsequently died. One patient (2.8%) developed progressive jaundice after TAE and died within 1 month, while four of the non-TAE cases died within 1 month after diagnosis. In general, TAE is safe for HCC patients with peripheral portal vein thrombosis. In addition, using Cox's regression model for multivariate survival analysis, serum total bilirubin (< or =, > 2 mg/dL; P = 0.0254), AFP (< or = 3155 ng/mL, > 3155 ng/mL; P = 0.0002) and treatments (TAE, non-TAE; P = 0.0059) were found to affect their prognosis. There was significant difference in survival between TAE and non-TAE groups, the 6 month, 1 year and 2 year survival rates were 91.4 versus 62.3%, 51.4 versus 26.2% and 17.1 versus 4.9% (P = 0.0017). The median survival times of TAE and non-TAE groups were 10.3 versus 3.7 months, respectively. Though TAE only provided palliative treatment, it did prolong survival in HCC patients with peripheral portal vein thrombosis.
为了评估经导管动脉栓塞术（TAE）对伴有门静脉周围血栓形成的肝细胞癌（HCC）患者的潜在益处，分析了96例连续性伴有门静脉周围血栓形成的HCC病例。其中，35例接受了TAE治疗，61例未接受。接受TAE治疗的大多数病例（77.8%）治疗后甲胎蛋白（AFP）水平下降，但其中57.1%的患者AFP水平随后再次升高并最终死亡。1例患者（2.8%）TAE治疗后出现进行性黄疸并在1个月内死亡，而4例未接受TAE治疗的患者在诊断后1个月内死亡。总体而言，TAE对伴有门静脉周围血栓形成的HCC患者是安全的。此外，使用Cox回归模型进行多因素生存分析，发现血清总胆红素（≤、＞2mg/dL；P = 0.0254）、AFP（≤3155ng/mL、＞3155ng/mL；P = 0.0002）和治疗方式（TAE、非TAE；P = 0.0059）影响患者预后。TAE组和非TAE组生存率存在显著差异，6个月、1年和2年生存率分别为91.4%对62.3%、51.4%对26.2%和17.1%对4.9%（P = 0.0017）。TAE组和非TAE组的中位生存时间分别为10.3个月和3.7个月。虽然TAE仅提供姑息性治疗，但它确实延长了伴有门静脉周围血栓形成的HCC患者的生存期。
