【摘要】 目的 探讨肝动脉灌注化疗术（HAIC）联合碘化油肝动脉化疗栓塞（C-TACE）治疗原发性肝癌（HCC）合并门静脉癌栓（PVTT）疗效及对血清恶性肿瘤特异性生长因子（TSGF）、甲胎蛋白（AFP）、异常凝血酶原（DCP）水平的影响。方法 选取2021年8月至2022年8月石家庄市第五医院收治的50例HCC合并PVTT患者，按治疗方法不同分为对照组25例（C-TACE治疗）和观察组25例（HAIC联合C-TACE治疗）。比较两组临床疗效、肝功能[谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBIL）]及血清TSGF、AFP、ADC水平和不良反应。采用Kaplan-Meier法进行生存分析。结果 观察组疾病控制率（DCR）高于对照组，差异有统计学意义（P<0.05）。治疗后，两组AST、ALT、TBIL均较治疗前降低，且观察组低于对照组，差异有统计学意义（P<0.05）；两组血清TSGF、AFP、ADC水平均较治疗前降低，且观察组低于对照组，差异有统计学意义（P<0.05）。两组不良反应发生情况比较差异无统计学意义（P>0.05）。Kaplan-Meier生存曲线显示，观察组中位生存时间为15.33月（95%CI:13.19～17.47），长于对照组12.87月（95%CI:10.81～14.93），观察组2年总生存率（56.0%）高于对照组（28.0%），差异有统计学意义（P<0.05）。结论 HAIC联合C-TACE治疗HCC合并PVTT患者的临床疗效显著，可减轻肝损伤，降低TSGF、AFP、ADC水平，延长生存期。更多还原

【Abstract】 Objective To investigate the efficacy of HAIC combined with conventional-transarterial C-TACE in treating primary HCC complicated with PVTT, and the impact on serum TSGF, AFP, and DCP. Methods From August 2021 to August 2022, 50 patients with HCC and PVTT were admitted to the Fifth Hospital of Shijiazhuang. They were selected and divided into two groups based on treatment methods: the ontrol group(25 cases treated with C-TACE) and the observation group(25 cases treated with HAIC combined with C-TACE). A comparison was made between the two groups in terms of clinical efficacy, liver function(AST, ALT, TBIL), serum TSGF, AFP, and DCP levels, as well as adverse events. Kaplan-Meier survival analysis was performed. Results The disease control rate(DCR) in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). After treatment, the levels of AST, ALT, TBIL, serum TSGF, AFP, and ADC in both groups were lower than before treatment, with the levels in the observation group being lower than those in the control group, showing statistically significant differences(P<0.05). The incidence of adverse events was comparable between the two groups(P>0.05). KaplanMeier analysis revealed that the median survival time of the observation group was 15.33 months(95%CI:13.19～17.47), which was longer than that of the control group at 12.87 months(95%CI:10.81～14.93). The 2-year overall survival rate of the observation group(56.0%) was higher than that of the control group(28.0%). All differences were statistically significant(P<0.05). Conclusion HAIC combined with C-TACE is highly effective in treating patients with HCC and PVTT. It can help alleviate liver damage, reduce serum levels of TSGF, AFP, and ADC, and extend survival.更多还原