葡聚糖微球肝栓塞治疗肝癌疗效的病理学评估

To evaluate the therapeutic effect and the mechanism of dextran hepatic artery embolization for hepatoma.Partial hepatectomy was performed in 11 patients with hepatoma pretreated by dextran hepatic artery embolization.All specimens were done for histopathologic studies in order to observe the destiny of dextran microspheres and necrotic degree of the tumor.Complete necrosis of the tumor was found in 7 cases of the patients and incomplete necrosis of the tumor in other 4.The tumors in incompletely necrotic group were nearer to areas in which the arterial collateral anastomoses are very rich.The necrotic degreee was related neither to the existence and thickness of tumor capsule nor to the tumor capsule invasions.Dextran microspheres could lead permanent distal arterial embolization.The microspheres were very biocompatible and of little foreign body reaction.No inflammatory changes seen inside and outside the embolized artery 191 days after embolization, dextran microspheres was not resorbed and the vessel recanalization was also not seen.Dextran microspheres were not found in portal vein system.So the hepatomas remote from collateral circulation could be cured with dextran hepatic artery embolization alone.