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目的 探讨可切除大肝癌TACE后手术切除标本的病理改变及其意义。方法 2002年1月～2003年1月收治的83例可切除大肝癌患者随机分成术前TACE组(36例)与一期手术组(47例),术前TACE组3l例二期切除(二期手术组),5例失去手术切除机会,78例术后病理均证实为肝细胞癌。对比两组标本问主瘤、包膜、子灶、癌栓、肝硬化等病理情况。结果 TACE组除较一期手术组肿瘤坏死广泛、包膜更完整外,两组间子灶及门脉癌栓发生率、肝外浸润转移无显著差异;TACE组TACE后肿瘤体积缩小并不显著,子灶、门脉癌栓完全坏死者少,肝硬化加重。结论 可切除大肝癌术前TACE不能使肿瘤完全坏死,部分患者耽误手术时机,应严格选择应用。
Objective To investigate the pathological changes of resectable large hepatocellular carcinoma after TACE and its significance. Methods From January 2002 to January 2003, 83 patients with resectable large hepatocellular carcinoma admitted to our hospital were randomly divided into two groups: preoperative TACE group (36 cases) and primary surgery group (47 cases), preoperative TACE group (31 cases) Stage surgery group), 5 cases lost the chance of surgical resection, 78 cases of pathology confirmed hepatocellular carcinoma. Compare two groups of specimens asked the main tumor, envelope, sub-focus, tumor emboli, cirrhosis and other pathological conditions. Results There was no significant difference between the two groups in incidence of tumor thrombosis and extrahepatic invasion and metastasis except for the extensive tumor necrosis and more complete capsule in the TACE group than in the first surgery group. TACE showed no significant decrease in tumor volume after TACE , Sub-stove, portal vein tumor thrombus completely necrosis less, increased liver cirrhosis. Conclusion Resectable large hepatocellular carcinoma before TACE can not make the tumor completely necrosis, some patients delay the timing of surgery should be strictly selected.