The Efficacy after TACE of Massive Hepatocarcinoma with Different Imaging Appearance_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGCheng-en ,  SUNCheng-jian , XIELing-ling , WANGYan-hua

Department of Interventional Radiology, The Affiliated Hospital of Qingdao University, Qingdo 266003, Shandong Province, China;

Corresponding author：

SUNCheng-jian, Email: chengjiansun2009@163.com

Keywords：

Massive hepatocarcinoma; Pseudocapsule; Chemoembolization

DOI：

10.7507/1007-9424.20140300

Video：

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Objective To investigate the clinical efficacy and mechansim of massive hepatocarcinoma with different imaging appearance after transcatheter arterial chemoembolization(TACE). Methods The image data of 38 patients with massive hepatocarcinoma were collected and analized retrospectively. According to the tumor edge situation on CT images before TACE treatment, the patients were divided into two groups:the sharp-edged tumor group and indistinct-edged tumor group. The efficacy were evaluated according to the imaging appearance after treatment. Results The differences of the positive cases of HbsAg and AFP, Child-Pugh class, maximum tumor diameter, and dosage of lipiodol between the two groups before procedure were not statistic significance(P > 0.05). Six months after TACE, the maximum tumor diameter of the sharp-edged tumor group and indistinct-edged tumor group was(8.2±1.48) cm and(12.2±1.67) cm, respectively, the difference between the two groups was statistic significance(P < 0.05). In accordance with lipiodol deposition, ⅠandⅡtype were found in the sharp-edged tumor group withoutⅢandⅣtype. Most wereⅡandⅢtype with lessⅠtype and severalⅣtype in the indistinct-edged tumor group. According to the size of tumor six months after TACE, the total effective rate(CR+PR) was 92.9% and 62.5%, respectively in the sharp-edged tumor group and indistinct-edged tumor group. There were significantly difference between the two groups in iodized oil distribution and tumor size after procedure(P < 0.05). No statistical difference was found between the incidence rate of complications in two groups(P > 0.05). Conclusion The efficacy of massive hepatocarcinoma in patients with sharp-edged tumor on CT images is better than those with indistinct-edged tumor.

Citation： WANGCheng-en, SUNCheng-jian, XIELing-ling, WANGYan-hua. The Efficacy after TACE of Massive Hepatocarcinoma with Different Imaging Appearance. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1254-1258. doi: 10.7507/1007-9424.20140300 Copy

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25.	姚昶, 陈德轩, 卞卫和, 等.生肌玉红胶原促进大鼠后肢缺血组织血管新生的实验研究[J].中国普外基础与临床杂志, 2013, 20(4):389-394.

1. 王小林, 龚高全, 王建华, 等.原发性巨块型肝癌经动脉大剂量碘化油栓塞的应用分析[J].复旦学报:医学版, 2009, 36(1):79-82.
2. Raoul JL, Sangro B, Forner A, et al. Evolving strategies for the management of intermediate-stage hepatocellular carcinoma:avai-lable evidence and expert opinion on the use of transarterial chemo-embolization[J]. Cancer Treat Rev, 2011, 37(3):212-220.
3. Burrel M, Reig M, Forner A, et al. Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design[J]. J Hepatol, 2012, 56(6):1330-1335.
4. Oliveri RS, Wetterslev J, Gluud C. Transarterial (chemo) embolisation for unresectable hepatocellular carcinoma[J]. Cochrane Database Syst Rev, 2011, (3):CD004787.
5. Shibata T, Isoda H, Hirokawa Y, et al. Small hepatocellular carcinoma:is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment?[J]. Radiology, 2009, 252(3):905-913.
6. Kim JH, Yoon HK, Sung KB, et al. Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma:clinical efficacy and factors influencing outcomes[J]. Cancer, 2008, 113(7):1614-1622.
7. Liapi E, Georgiades CC, Hong K, et al. Transcatheter arterial chemoembolization:current technique and future promise[J]. Tech Vasc Interv Radiol, 2007, 10(1):2-11.
8. 纪洪生, 张振海, 陈颉, 等.肝癌介入术后碘化油沉积CT表现及临床意义[J].医学影像学杂志, 2011, 21(7):1027-1029.
9. Zheng K, Shen J, Wang G, et al. Small hepatocellular carcinoma with peripheral enhancement:pathological correlation with dual phase images by helical CT[J]. Chin Med J (Engl), 2007, 120(18):1583-1586.
10. Grazioli L, Olivetti L, Fugazzola C, et al. The pseudocapsule in hepatocellular carcinoma:correlation between dynamic MR imaging and pathology[J]. Eur Radiol, 1999, 9(1):62-67.
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. 常秀娟, 陆荫英, 白文林, 等.氩氦冷冻消融治疗进展期肝癌的疗效及其影响因素研究[J].肝脏, 2010, 15(1):11-14.
13. Folkman J, Merler E, Abernathy C, et al. Isolation of a tumor factor responsible for angiogenesis[J]. J Exp Med, 1971, 133(2):275-288.
14. Folkman J, Shing F. Angiogenesis[J]. J Biol Chem, 1992, 267(16):10931-10934.
15. Moon WS, Rhyu KH, Kang MJ, et al. Overexpression of VEGF and angiopoietin 2:a key to high vascularity of hepatocellular carcinoma?[J]. Mod Pathol, 2003, 16(6):552-557.
16. Wang B, Xu H, Gao ZQ, et al. Increased expression of vascular endothelial growth factor in hepatocellular carcinoma after transcatheter arterial chemoembolization[J]. Acta Radiol, 2008, 49(5):523-529.
17. 于德新, 王滨, 周茂义, 等.肝细胞癌螺旋CT表现特征与VEGF、bFGF表达和血管生成关系的研究[J].中国医学影像技术, 2004, 20(7):1076-1079.
18. Shim JH, Park JW, Kim JH, et al. Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients[J]. Cancer Sci, 2008, 99(10):2037-2044.
19. Land SC, Tee AR. Hypoxia-inducible factor 1αis regulated by the mammalian target of rapamycin (mTOR) via an mTOR signaling motif[J]. J Biol Chem, 2007, 282(28):20534-20543.
20. Rey S, Semenza GL. Hypoxia-inducible factor-1-dependent mechanisms of vascularization and vascular remodelling[J]. Cardiovasc Res, 2010, 86(2):236-242.
21. Yang ZF, Poon RT, To J, et al. The potential role of hypoxia inducible factor 1αin tumor progression after hypoxia and chemotherapy in hepatocellular carcinoma[J]. Cancer Res, 2004, 64(15):5496-5503.
22. Fujiwara S, Nakagawa K, Harada H, et al. Silencing hypoxia-inducible factor-1αinhibits cell migration and invasion under hypoxic environment in malignant gliomas[J]. Int J Oncol, 2007, 30(4):793-802.
23. Mabjeesh NJ, Amir S. Hypoxia-inducible factor (HIF) in human tumorigenesis[J]. Histol Histopathol, 2007, 22(5):559-572.
24. 熊义富.肝细胞肝癌多层螺旋CT征象与肿瘤血管生成相关性的研究[D].川北医学院, 2013.
25. 姚昶, 陈德轩, 卞卫和, 等.生肌玉红胶原促进大鼠后肢缺血组织血管新生的实验研究[J].中国普外基础与临床杂志, 2013, 20(4):389-394.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Efficacy after TACE of Massive Hepatocarcinoma with Different Imaging Appearance

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