Kanai T, Monden M, Sakon M, Gotoh M, Umeshita K, Hasuike Y, Nakano H, Monden T, Murakami T, Nakamura H
Department of Surgery II, Osaka University Medical School, Japan.
Cancer Chemother Pharmacol. 1994;33 Suppl:S48-54. doi: 10.1007/BF00686668.
The prognosis of patients with multiple hepatocellular carcinoma (HCC) remains disappointing. In this study, we devised a new therapeutic modality for HCC consisting of transarterial immunoembolization (TIE) using OK-432 and fibrinogen and then analyzed the preliminary results. In the first series, we applied the treatment to 19 patients with advanced HCC who had proved to be insensitive to several previous conventional treatments. In all, 14 patients (74%) with unresected HCC have currently survived for between 2 and 16 months after TIE. The remaining 5 patients died at 17, 14, 8, 7, and 4 months after TIE. The serum levels of tumor markers decreased in all of the patients, and a marked reduction in tumor size was observed in six patients after TIE. A high fever occurred in all cases, and abdominal pain and loss of appetite were also observed after TIE. However, deterioration of liver function was negligible. After confirmation of the safety of this method, we started a second study series in which this TIE treatment was selected as the first choice. Six patients have been treated to date. All patients in this group underwent hepatic resection at 6-48 days following TIE. Histological examination of the resected specimens following TIE showed massive infiltration of mononuclear cells around tumor cell nests and lytic necrosis as well as coagulation necrosis of the main tumor and the intrahepatic metastases. In conclusion, our results indicate that TIE may be a safe and promising therapy for patients with HCC.
多发性肝细胞癌（HCC）患者的预后仍然令人失望。在本研究中，我们设计了一种新的HCC治疗方法，即使用OK-432和纤维蛋白原进行经动脉免疫栓塞（TIE），然后分析初步结果。在第一个系列中，我们将该治疗应用于19例晚期HCC患者，这些患者已被证明对先前的几种传统治疗不敏感。总体而言，14例（74%）未切除HCC的患者在TIE后目前已存活2至16个月。其余5例患者在TIE后17、14、8、7和4个月死亡。所有患者的肿瘤标志物血清水平均下降，6例患者在TIE后观察到肿瘤大小明显缩小。所有病例均出现高热，TIE后还观察到腹痛和食欲不振。然而，肝功能恶化可忽略不计。在确认该方法的安全性后，我们开始了第二个研究系列，其中将这种TIE治疗作为首选。迄今为止，已有6例患者接受了治疗。该组所有患者在TIE后6至48天接受了肝切除术。TIE后切除标本的组织学检查显示，肿瘤细胞巢周围有大量单核细胞浸润，以及主要肿瘤和肝内转移灶的溶解性坏死和凝固性坏死。总之，我们的结果表明，TIE可能是一种对HCC患者安全且有前景的治疗方法。
