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目的 探讨原位肝移植技术在治疗原发性肝癌中的地位和疗效。方法 对 1993年 4月至 2 0 0 0年 6月中山医科大学器官移植中心进行的 2 0例原位肝移植术治疗原发性肝癌临床资料进行回顾性研究。其中大肝癌 14例 (直径 >5cm) ,小肝癌 6例 (直径≤ 5cm)。结果 大肝癌组肝移植术后平均存活 6 5个月 ,肝癌复发率为 71% (10 / 14) ;小肝癌组移植术后 1、2年存活率分别为 83 % (5 /6 )和 6 7% (4 / 6 ) ,肝癌复发率为 17% (1/ 6 ) ,两组肝癌复发率的差异有显著意义 (P <0 0 5 )。结论肝移植对肝癌单发 ,直径小于或等于 5cm ,无血管侵犯的小肝癌有良好的疗效 ;对部分病例选择适当的大肝癌患者可获得较好的姑息疗效 ;肝移植围手术期辅助化学药物治疗可能会减少肝癌复发。
Objective To investigate the status and efficacy of orthotopic liver transplantation in the treatment of primary liver cancer. Methods A retrospective study was conducted on the clinical data of 20 primary liver cancer patients treated with orthotopic liver transplantation performed at the Organ Transplantation Center of Zhongshan Medical University from April 1993 to June 2000. Among them, 14 cases of large liver cancer (diameter >5cm) and 6 cases of small liver cancer (diameter ≤ 5cm). Results The liver cancer patients survived for an average of 65 months after liver transplantation. The recurrence rate of hepatocellular carcinoma was 71% (10 / 14). The 1-year and 2-year survival rates of the small hepatocellular carcinoma group were 83% (5 / 6) and 6 respectively. 7% (4 / 6), liver cancer recurrence rate was 17% (1/6), the difference between the two groups of liver cancer recurrence rate was significant (P <0 05). Conclusions Liver transplantation has good curative effect on small hepatocellular carcinoma with single hepatic cancer less than or equal to 5cm in diameter and no vascular invasion. Patients with large hepatocellular carcinoma who choose appropriate cases can obtain better palliative effect; Perioperative adjuvant chemotherapy for liver transplantation Treatment may reduce the recurrence of liver cancer.