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目的:探讨肝癌术后复发再次手术切除后辅以肝动脉化疗栓塞术(TACE)、经皮微波固化治疗术(PMCT)联合门静脉化疗术(PVC)治疗的临床疗效。方法:纳入80例确诊为肝细胞癌复发患者作为研究对象,所有患者均再次行手术切除治疗,术后根据其是否辅以PVC分为化疗组与未化疗组,其中化疗组术后采用TACE+PMCT+PVC治疗,未化疗组给予TACE+PMCT治疗。比较两组临床疗效,于术前,1个疗程完成后3 d、1、3周观察患者血清AFP、CEA水平的变化,随访1年比较两组患者的生存率。结果:所有患者1个疗程后3 d及1周血清AFP高于术前,但差异无统计学意义(P>0.05),1疗程后3周明显低于术前,差异有统计学意义(P<0.05),且化疗组明显低于未化疗组(P<0.05);1疗程后CEA水平均明显下降,且不同时间段化疗组均明显低于未化疗组,差异有统计学意义(P<0.05)。化疗组随访6个月、1年复发率为7.5%、22.5%,明显低于未化疗组的25.0%、45.0%;而生存率为92.5%、85.0%,高于未化疗组的77.5%、65.0%,差异均有统计学意义(P<0.05)。结论:对肝癌术后复发患者再次手术后行TACE+PMCT+PVC治疗,可以明显降低患者血清AFP、CEA水平,同时有效降低患者的复发率,延长其生存时间,改善长期预后。
Objective: To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with percutaneous microwave solidification (PMCT) and portal vein chemotherapy (PVC) after resection of liver cancer. Methods: Totally 80 patients with recurrent hepatocellular carcinoma were enrolled in this study. All patients underwent surgical resection. According to whether they were supplemented with PVC or not, they were divided into chemotherapy group and non-chemotherapy group. TACE + PMCT + PVC treatment, non-chemotherapy group given TACE + PMCT treatment. The clinical efficacy of the two groups were compared. The levels of serum AFP and CEA in the patients were observed before operation, 3 days and 1 week and 3 weeks after the completion of one course of treatment. The survival rates of the two groups were compared after one year follow-up. Results: The serum AFP level at 3 days and 1 week after one course of treatment in all patients was significantly higher than that before operation (P> 0.05). The level of serum AFP was significantly lower than preoperative one week after the first course of treatment (P <0.05), and the chemotherapy group was significantly lower than the non-chemotherapy group (P <0.05); CEA levels were significantly decreased after 1 course of treatment, and the chemotherapy group at different time were significantly lower than the non-chemotherapy group, the difference was statistically significant (P < 0.05). The chemotherapy group was followed up for 6 months. The 1-year recurrence rate was 7.5% and 22.5%, which was significantly lower than that of the non-chemotherapy group (25.0% and 45.0%). The survival rates were 92.5% and 85.0% 65.0%, the differences were statistically significant (P <0.05). Conclusion: TACE + PMCT + PVC treatment after reoperation in patients with recurrent liver cancer can significantly reduce serum AFP and CEA levels, reduce the recurrence rate, prolong their survival time and improve long-term prognosis.