RESPONSE OF EARLY-STAGE HEPATOCELLULAR-CARCINOMA AND BORDERLINE LESIONS TO THERAPEUTIC ARTERIAL EMBOLIZATION

被引:54
作者
TAKAYASU, K
WAKAO, F
MORIYAMA, N
MURAMATSU, Y
SAKAMOTO, M
HIROHASHI, S
MAKUUCHI, M
KOSUGE, T
TAKAYAMA, T
YAMAZAKI, S
机构
[1] NATL CANC CTR,RES INST,DIV PATHOL,CHUO KU,TOKYO 104,JAPAN
[2] SHINSHU UNIV,SCH MED,DEPT SURG 1,MATSUMOTO,NAGANO 390,JAPAN
[3] NATL CANC CTR,DEPT SURG,CHUO KU,TOKYO 104,JAPAN
关键词
D O I
10.2214/ajr.160.2.8380949
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. In Japan, borderline lesions and early-stage hepatocellular carcinoma (HCC) are now histopathologically divided into two subgroups; one includes adenomatous hyperplasia and atypical adenomatous hyperplasia, and the other includes early HCC and early advanced HCC. In order to evaluate the efficacy of transcatheter arterial embolization for treating such lesions, histopathologic studies were done after embolization and resection in 27 patients. MATERIALS AND METHODS. The lesions consisted of two adenomatous hyperplasias, one atypical adenomatous hyperplasia, 22 early HCCs, and 13 early advanced HCCs. All patients had chronic liver diseases in nontumorous parenchyma in addition to HCC. For transcatheter arterial embolization, one of the following embolizing materials was used: iodized oil (Lipiodol) alone (n = 4), an emulsion of doxorubicin in Lipiodol (n = 8), and the same emulsion followed by gelatin sponge particles (n = 15). RESULTS. The frequencies of tumor stain on the angiogram and retention of Lipiodol within the tumor were 84% and 94% in overt HCC, 23% and 69% in early advanced HCC, and 9% and 9% in early HCC, respectively. The average size of overt HCC was significantly (p < .01) larger than that of early advanced HCC and early HCC. The amount of necrosis induced by embolization relative to the size of the mass was 56% on average in overt HCCs, 14% in early advanced HCCs, and 0% in early HCCs, atypical adenomatous hyperplasias, and adenomatous hyperplasias. Significant differences (p < .01) in mean necrosis rate were seen between overt HCCs and early advanced HCCs, between early advanced HCCs and early HCCs, and between overt HCCs and early HCCs. The frequency of Lipiodol retention correlated with mean necrosis rate for tumor. With reference to therapeutic techniques, only for the overt HCCs was a significant difference (p < .01) in the mean necrosis rate found between the group that received the emulsion of doxorubicin in Lipiodol and the group that received the emulsion and then particles of gelatin. CONCLUSION. This study suggests that transcatheter arterial embolization has limited efficacy for treating early-stage HCC and borderline lesions compared with its efficacy for treating overt HCC.
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页码:301 / 306
页数:6
相关论文
共 25 条
[1]   EMERGENCE OF MALIGNANT LESIONS WITHIN AN ADENOMATOUS HYPERPLASTIC NODULE IN A CIRRHOTIC LIVER - OBSERVATIONS IN 5 CASES [J].
ARAKAWA, M ;
KAGE, M ;
SUGIHARA, S ;
NAKASHIMA, T ;
SUENAGA, M ;
OKUDA, K .
GASTROENTEROLOGY, 1986, 91 (01) :198-208
[2]  
CHEN DS, 1982, GASTROENTEROLOGY, V83, P1109
[3]   THERAPEUTIC EFFECT OF TRANSCATHETER OILY CHEMOEMBOLIZATION THERAPY FOR ENCAPSULATED NODULAR HEPATOCELLULAR-CARCINOMA - CT AND PATHOLOGICAL FINDINGS [J].
CHOI, BI ;
KIM, HC ;
HAN, JK ;
PARK, JH ;
KIM, YI ;
KIM, ST ;
LEE, HS ;
KIM, CY ;
HAN, MC .
RADIOLOGY, 1992, 182 (03) :709-713
[4]  
KANAI T, 1987, CANCER, V60, P810, DOI 10.1002/1097-0142(19870815)60:4<810::AID-CNCR2820600417>3.0.CO
[5]  
2-1
[6]  
KENMOCHI K, 1987, LIVER, V7, P18
[7]  
Kojiro M, 1991, GANN MONOGRAPH CANCE, V38, P29
[8]  
KONDO Y, 1991, GANN MONOGR CANCER R, V38, P39
[9]   ADENOMATOUS HYPERPLASTIC NODULES IN THE CIRRHOTIC LIVER - A THERAPEUTIC APPROACH - WORK IN PROGRESS [J].
LIVRAGHI, T ;
SANGALLI, G ;
VETTORI, C .
RADIOLOGY, 1989, 170 (01) :155-157
[10]   BENIGN AND MALIGNANT NODULES IN CIRRHOTIC LIVERS - DISTINCTION BASED ON BLOOD-SUPPLY [J].
MATSUI, O ;
KADOYA, M ;
KAMEYAMA, T ;
YOSHIKAWA, J ;
TAKASHIMA, T ;
NAKANUMA, Y ;
UNOURA, M ;
KOBAYASHI, K ;
IZUMI, R ;
IDA, M ;
KITAGAWA, K .
RADIOLOGY, 1991, 178 (02) :493-497