全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

原发性肝癌首次TACE治疗时RIPA参与肿瘤供血的影响因素分析

, PP. 1388-1392

Keywords: 原发性肝癌,经动脉插管化疗栓塞,右侧膈下动脉,肿瘤血供,影响因素

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的分析原发性肝癌首次经动脉插管化疗栓塞时右侧膈下动脉(rightinferiorphrenicartery,RIPA)参与肿瘤供血的相关影响因素,作为术前判断其是否存在供血的重要参考依据。方法回顾性分析我院161例原发性肝癌首次行插管化疗栓塞时即行右侧膈下动脉造影者的MRI或CT、DSA资料,按肿瘤是否有RIPA参与供血分RIPA组与NRIPA组,分析两组病例肿瘤大小、位置、包膜,并对其行单因素分析及多因素logistic回归分析。结果161例中RIPA参与肿瘤供血77例(47.8%),单因素分析显示肿瘤大小(P<0.01)、是否累及肝包膜(P=0.034)、肿瘤有无完整包膜(P<0.01)、肿瘤主要部分所在肝段(P<0.01)在两组间有统计学差异,多因素logistic回归分析显示肿瘤大小分类、有无完整包膜及肿瘤主要部分所在肝段为首次TACE治疗时RIPA参与肿瘤供血的独立预测因素。结论原发性肝癌首次TACE治疗时,当肿瘤为位于肝裸区或膈下的大肝癌,尤其是位于VII段且无完整包膜者,RIPA参与肿瘤供血的机会增加。

References

[1]  Mitchell J W, O'Connell W G, Kisza P, et al. Safety and feasibility of outpatient transcatheter hepatic arterial embolization for hepatocellular carcinoma[J]. J Vasc Interv Radiol, 2009, 20(2): 203-208. [2]Paul S B, Gamanagatti S R, Mukund A, et al. Transarterial chemoembolization for hepatocellular carcinoma:? significance of extrahepatic collateral supply[J]. Indian J Cancer, 2011, 48(3): 339-344. [3]Cheng L F, Ma K F, Fan W C, et al. Hepatocellular carcinoma with extrahepatic collateral arterial supply[J]. J Med Imaging Radiat Oncol, 2010, 54(1):? 26-34. [4]Kim H C, Chung J W, An S, et al. Hepatocellular carcinoma:? detection of blood supply from the right inferior phrenic artery by the use of multi-detector row CT[J]. J Vasc Interv Radiol, 2008, 19(11): 1551-1557. [5]Hieda M, Toyota N, Kakizawa H, et al. Evaluation of hepatocellular carcinoma supplied by the right inferior phrenic artery at initial treatment[J]. J Comput Assist Tomogr, 2008, 32(6): 877-881. [6]刘杨安, 刘富瑶, 张二雷, 等. 无肿瘤包膜的肝细胞癌临床病理特征及术后预后分析[J]. 华中科技大学学报: 医学版, 2013, 42(5): 592-596. [7]Jun L, Zhenlin Y, Renyan G, et al. Independent factors and predictive score for extrahepatic metastasis of hepatocellular carcinoma following curative hepatectomy[J]. Oncologist, 2012, 17(7):? 963-969. [8]Kim I, Kim M J. Histologic characteristics of hepatocellular carcinomas showing atypical enhancement patterns on 4-phase MDCT examination[J]. Korean J Radiol, 2012, 13(5):? 586-593. [9]Cazejust J, Bessoud B, Colignon N, et al. Hepatocellular carcinoma vascularization:? from the most common to the lesser known arteries[J]. Diagn Interv Imaging, 2014, 95(1): 27-36. [10]中华人民共和国卫生部. 原发性肝癌诊疗规范(2011年版)[J]. 临床肿瘤学杂志, 2011, 16(10): 929-946. [11]Ishigami K, Yoshimitsu K, Nishihara Y, et al. Hepatocellular carcinoma with a pseudocapsule on gadolinium-enhanced MR images:? correlation with histopathologic findings[J]. Radiology, 2009, 250(2): 435-443. [12]Miyayama S, Yamashiro M, Okuda M, et al. Chemoembolization for the treatment of large hepatocellular carcinoma[J]. J Vasc Interv Radiol, 2010, 21(8): 1226-1234. [13]Gwon D I, Ko G Y, Yoon H K, et al. Inferior phrenic artery:? anatomy, variations, pathologic conditions, and interventional management[J]. Radiographics, 2007, 27(3): 687-705. [14]Chung J W, Kim H C, Yoon J H, et al. Transcatheter arterial chemoembolization of hepatocellular carcinoma:? prevalence and causative factors of extrahepatic collateral arteries in 479 patients[J]. Korean J Radiol, 2006, 7(4):? 257-266. [15]Chen G W, Song B, Li Z L, et al. Ectopic blood supply of hepatocellular carcinoma as depicted by angiography with computed tomography:? associations with morphological features and therapeutic history[J]. PLoS One, 2013, 8(8):? e71942. [16]李华南, 成艺, 潘素珍. 膈下动脉参与肝脏肿瘤供血的影像与介入治疗[J]. 医学理论与实践, 2014, 27(8):? 1044-1045. [17]傅晓明, 刘圣, 施海彬, 等. 原发性肝癌右膈下动脉的栓塞治疗[J]. 江苏医药, 2011, 37(2): 199-200, 封2. [18]Miyayama S, Yamashiro M, Shibata Y, et al. Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization [J]. Jpn J Radiol, 2012, 30(1):? 45-52. [19]Miyayama S, Yamashiro M, Yoshie Y, et al. Inferior phrenic arteries:? angiographic anatomy, variations, and catheterization techniques for transcatheter arterial chemoembolization[J]. Jpn J Radiol, 2010, 28(7): 502-511. [20]青云, 罗小平, 刘曦, 等. 右侧膈下动脉起源及其在原发性肝癌中参与供血的影像特征[J]. 第三军医大学学报, 2014, 36(5): 478-482.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133