肝細胞癌に対する部分的脾動脈塞栓術併用肝動脈化学塞栓療法の臨床的意義
血小板減少を伴う肝細胞癌に対し，部分的脾動脈塞栓術（Partial splenic arterial embolization: PSE）と肝動脈化学塞栓療法（transcatheter arterial chemoembolization: TACE）を同時施行した症例の検討を行った．対象は血小板減少を伴う肝細胞癌症例に対し，TACEと同時にPSEを施行した術前血小板数5万/μl以下の23症例である．平均脾梗塞率は55.19％であり，術前平均血小板値は4.41万/μlで，術後平均血小板値は7.58万/μlに上昇した．血小板の上昇により，RFAを含めた穿刺治療は可能となった．血小板減少のために...
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| Published in | Japanese Journal of Portal Hypertension Vol. 19; no. 4; pp. 179 - 181 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本門脈圧亢進症学会
2013
The Japan Society for Portal Hypertension |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1344-8447 2186-6376 |
| DOI | 10.11423/jsph.19.179 |
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| Abstract | 血小板減少を伴う肝細胞癌に対し，部分的脾動脈塞栓術（Partial splenic arterial embolization: PSE）と肝動脈化学塞栓療法（transcatheter arterial chemoembolization: TACE）を同時施行した症例の検討を行った．対象は血小板減少を伴う肝細胞癌症例に対し，TACEと同時にPSEを施行した術前血小板数5万/μl以下の23症例である．平均脾梗塞率は55.19％であり，術前平均血小板値は4.41万/μlで，術後平均血小板値は7.58万/μlに上昇した．血小板の上昇により，RFAを含めた穿刺治療は可能となった．血小板減少のためにTACE，RFAが困難な進行肝細胞癌症例に対し，PSEを同時併用することで，血小板を増加させ，治療を継続することができ，集学的治療の一環としてのPSEの有用性が示唆された． |
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| AbstractList | 血小板減少を伴う肝細胞癌に対し，部分的脾動脈塞栓術（Partial splenic arterial embolization: PSE）と肝動脈化学塞栓療法（transcatheter arterial chemoembolization: TACE）を同時施行した症例の検討を行った．対象は血小板減少を伴う肝細胞癌症例に対し，TACEと同時にPSEを施行した術前血小板数5万/μl以下の23症例である．平均脾梗塞率は55.19％であり，術前平均血小板値は4.41万/μlで，術後平均血小板値は7.58万/μlに上昇した．血小板の上昇により，RFAを含めた穿刺治療は可能となった．血小板減少のためにTACE，RFAが困難な進行肝細胞癌症例に対し，PSEを同時併用することで，血小板を増加させ，治療を継続することができ，集学的治療の一環としてのPSEの有用性が示唆された． |
| Author | 岩永, 明人 堀米, 亮子 木村, 成宏 本田, 博樹 関, 慶一 窪田, 智之 本間, 照 石川, 達 吉田, 俊明 |
| Author_FL | Ishikawa T Honma T Kubota T Yoshida T Seki K Iwanaga A Horigome R Honda H Kimura N |
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| DocumentTitleAlternate | Clinical significance of concurrent transcatheter arterial chemoembolization and partial splenic embolization for hepatocellular carcinoma |
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| References | 9) Waghorn DJ: Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J Clin Pathol 2001; 54: 214-218 4) Spigos DG, Jonasson O, Mozes M, Capek V: Partial splenic embolization in the treatment of hypersplenism. Am J Roentgenol 1979; 132: 777-782 13) Miyake Y, Ando M, Kaji E, et al: Partial splenic embolization prior to combination therapy of interferon and ribavirin in chronic hepatitis C patients with thrombocytopenia. Hepatol Res 2008; 38: 980-986 1) Takayasu K, Arii S, Ikai I, et al: Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 2006; 131: 461-469 6) Styrt B: Infection associated with asplenia: risks, mechanisms,and prevention. Am J Med 1990; 88: 33N-42N 15) McGahan JP, Browning PD, Brock JM, et al: Hepatic ablation using radiofrequency electrocautery. Invest Radiol 1990; 25: 267-270 5) 高塚健太郎，岩渕省吾，吉松英輝：新しい部分的脾動脈塞栓術（PSE）の手技と効果．日門亢会誌 2005; 11: 286-293 10) Brigden ML, Pattullo AL: Prevention and management of overwhelming postsplenectomy infection — an update. Crit Care Med 1999; 27: 836-842 17) Kainuma O, Asano T, Aoyama H, et al: Recurrent hepatocellular carcinoma successfully treated with radiofrequency thermal ablation. J Hepatobiliary Pancreat Surg 1999; 6: 190-194 3) Torrance G: Splenectomy in Banti's Disease, with Report of a Case. Ann Surg 1908; 47: 41-52 11) Maddison FE: Embolic therapy of hypersplenism．Invest Radiol 1973; 8: 280-281 8) Cullingford GL, Watkins DN, Watts AD, et al: Severe late postsplenectomy infection. Br J Surg 1991; 78: 716-721 16) Rossi S, Fornari F, Buscarini L: Percutaneous ultrasound-guided radiofrequency electrocautery for the treatment of small hepatocellular carcinoma. J Intervent Radiol 1993; 8: 97-103 18) Kagawa T, Koizumi J, Kojima S, et al: Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection. Cancer 2010; 116: 3638-3644 14) Hidaka H, Kokubu S, Nakazawa T, et al: Therapeutic benefits of partial splenic embolization for thrombocytopenia in hepatocellular carcinoma patients treated with radiofrequency ablation. Hepatol Res 2009; 39: 772-778 2) Shiina S, Tateishi R, Arano T, et al: Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol 2012; 107: 569-577 7) Lortan JE: Management of asplenic patients. Br J Haematol 1993; 84: 566-569 12) Yoshida H, Mamada Y, Taniai N, et al: Partial splenic embolization. Hepatol Res 2008; 38: 225-233 |
| References_xml | – reference: 3) Torrance G: Splenectomy in Banti's Disease, with Report of a Case. Ann Surg 1908; 47: 41-52 – reference: 7) Lortan JE: Management of asplenic patients. Br J Haematol 1993; 84: 566-569 – reference: 9) Waghorn DJ: Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed. J Clin Pathol 2001; 54: 214-218 – reference: 5) 高塚健太郎，岩渕省吾，吉松英輝：新しい部分的脾動脈塞栓術（PSE）の手技と効果．日門亢会誌 2005; 11: 286-293 – reference: 1) Takayasu K, Arii S, Ikai I, et al: Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 2006; 131: 461-469 – reference: 14) Hidaka H, Kokubu S, Nakazawa T, et al: Therapeutic benefits of partial splenic embolization for thrombocytopenia in hepatocellular carcinoma patients treated with radiofrequency ablation. Hepatol Res 2009; 39: 772-778 – reference: 6) Styrt B: Infection associated with asplenia: risks, mechanisms,and prevention. Am J Med 1990; 88: 33N-42N – reference: 13) Miyake Y, Ando M, Kaji E, et al: Partial splenic embolization prior to combination therapy of interferon and ribavirin in chronic hepatitis C patients with thrombocytopenia. Hepatol Res 2008; 38: 980-986 – reference: 11) Maddison FE: Embolic therapy of hypersplenism．Invest Radiol 1973; 8: 280-281 – reference: 16) Rossi S, Fornari F, Buscarini L: Percutaneous ultrasound-guided radiofrequency electrocautery for the treatment of small hepatocellular carcinoma. J Intervent Radiol 1993; 8: 97-103 – reference: 12) Yoshida H, Mamada Y, Taniai N, et al: Partial splenic embolization. Hepatol Res 2008; 38: 225-233 – reference: 17) Kainuma O, Asano T, Aoyama H, et al: Recurrent hepatocellular carcinoma successfully treated with radiofrequency thermal ablation. J Hepatobiliary Pancreat Surg 1999; 6: 190-194 – reference: 18) Kagawa T, Koizumi J, Kojima S, et al: Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection. Cancer 2010; 116: 3638-3644 – reference: 10) Brigden ML, Pattullo AL: Prevention and management of overwhelming postsplenectomy infection — an update. Crit Care Med 1999; 27: 836-842 – reference: 4) Spigos DG, Jonasson O, Mozes M, Capek V: Partial splenic embolization in the treatment of hypersplenism. Am J Roentgenol 1979; 132: 777-782 – reference: 15) McGahan JP, Browning PD, Brock JM, et al: Hepatic ablation using radiofrequency electrocautery. Invest Radiol 1990; 25: 267-270 – reference: 2) Shiina S, Tateishi R, Arano T, et al: Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol 2012; 107: 569-577 – reference: 8) Cullingford GL, Watkins DN, Watts AD, et al: Severe late postsplenectomy infection. Br J Surg 1991; 78: 716-721 |
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| Snippet | 血小板減少を伴う肝細胞癌に対し，部分的脾動脈塞栓術（Partial splenic arterial embolization: PSE）と肝動脈化学塞栓療法（transcatheter arterial chemoembolization:... |
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| SubjectTerms | hepatocellular carcinoma partial splenic arterial embolization radiofrequency ablation thrombocytopenia transcatheter arterial chemoembolization |
| Title | 肝細胞癌に対する部分的脾動脈塞栓術併用肝動脈化学塞栓療法の臨床的意義 |
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