臨床外科64巻7号

2009年07月発行

特集 肝胆膵癌に対する補助療法―治療成績の向上を目指して

C型肝炎関連肝細胞癌治療におけるインターフェロン治療の臨床的意義

著者： 久保正二¹ 竹村茂一¹ 上西崇弘¹ 塚本忠司² 田中宏³

所属機関： ¹大阪市立大学大学院医学研究科肝胆膵外科学 ²大阪市立総合医療センター肝胆膵外科 ³東住吉森本病院外科

ページ範囲：P.893 - P.899

要旨：C型肝炎関連肝細胞癌は根治術後においても高率に癌再発をきたす．その再発には転移再発と多中心性再発が含まれ，そのうち多中心性再発は併存する活動性肝炎と肝線維化による高い発癌ポテンシャルに影響される．インターフェロン治療によるHCV RNAの除去や肝炎鎮静化による発癌ポテンシャルの制御によって多中心性再発は抑制される．さらに，併存肝疾患の悪化を防ぐことによって，たとえ再発をきたしても根治的治療が可能となる結果，肝臓関連死亡を減少させる．インターフェロン治療などによって発癌ポテンシャルが制御可能となった，あるいは可能と予測される症例では転移再発予防を重視した系統的肝切除の役割が重要となる．

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