【摘要】 目的观察肝动脉化疗栓塞术治疗原发性肝癌的临床疗效及对患者血清甲胎蛋白（AFP）、甲胎蛋白异质体（AFP-L3）、肝功能的影响。方法选取2015年10月至2017年2月收治的原发性肝癌患者80例,随机分为对照组和观察组,每组40例。对照组给予常规化疗,观察组实施肝动脉化疗栓塞术治疗。观察2组临床疗效、外周血AFP、AFP-L3、肿瘤直径、谷丙转氨酶（ALT）、总胆红素（TBIL）、白蛋白（ALB）、T淋巴细胞亚群（CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺）、自然杀伤细胞（NK）水平变化、生活质量改善情况及1年、2年存活率。结果对照组、观察组总有效率分别为75.00%、87.50%,观察组总有效率较对照组显著提高,差异有统计学意义（P<0.05）。2组治疗后AFP、AFPL3、肿瘤直径、ALT、TBIL、CD₈⁺均较治疗前显著降低,ALB、CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺、NK细胞水平及KPS评分均较治疗前显著升高,差异有统计学意义（P<0.05）,且观察组改善程度优于对照组（P<0.05）。对照组1年、2年存活率分别为55.00%、67.50%,观察组1年、2年存活率分别为67.50%、80.00%,观察组1年、2年存活率较对照组显著升高,差异有统计学意义（P<0.05）。结论肝动脉化疗栓塞术治疗原发性肝癌疗效显著,能够明显改善患者肝功能;AFP-L3是能够准确反映肝动脉化疗栓塞术后疗效的肿瘤标志物。更多还原

【Abstract】 Objective To observe the therapeutic effects of hepatic arterial chemoembolization on primary liver cancer and its effects on serum alphafetoprotein（ AFP）,alphafetoprotein heteroplasmon（ AFP-L3） and liver function of patients with primary liver cancer. Methods A total of 80 patients with primary hepatocellular carcinoma who were admitted and treated in our hospital from October 2015 to February 2017 were randomly divided into observation group（ n = 40） and control group（ n = 40）. The patients in control group were treated by conventional chemotherapy,however,the patients in observation group were treated by hepatic arterial chemoembolization. The therapeutic effects,the changes of AFP,AFP-L3,tumor diameter,ALT,TBIL,ALB,T lymphocyte subsets（ CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺）,NK cells,improvement status of life quality and 1-year and 2-year survival rates of patients were observed and compared between two groups. Results The total effective rate in control group and observation group was 75. 00% and 87. 50%,respectively,there was a significant difference between two groups（ P < 0. 05）. As compared with those before treatment,the levels of AFP,AFP-L3,tumor diameter,ALT,TBIL,CD₈⁺were significantly decreased after treatment in both groups,however,the levels of ALB,CD₃⁺,CD₄⁺,CD₄⁺/CD₈⁺,NK cells and KPS scores were significantly increased after treatment in both groups（ P < 0. 05）,moreover,the improvement degree of these indexes in observation group was superior to that in control group（ P < 0. 05）. The 1-year and 2-year survival rates in observation group were 67. 50% and 80. 00%,respectively,which were significantly higher than those（ 55. 00% and67. 50%） in control group（ P < 0. 05）. Conclusion The hepatic arterial chemoembolization has obvious therapeutic effects on advanced primary hepatocellular carcinoma,which can obviously improve patient’s liver function,moreover,as compared with AFP,AFP-L3 is a more accurate tumor marker in evaluating therapeutic effects of hepatic arterial chemoembolization.更多还原