【摘要】 目的 探讨经导管动脉栓塞化疗（TACE）序贯微波消融（MVA）治疗中晚期肝细胞癌（HCC）的临床疗效。方法 收集2019年1月至2021年12月青海省第四人民医院收治的140例中晚期HCC患者的临床资料。根据治疗方法的不同分为TACE组（n=51，给予TACE治疗）和联合组（n=89，给予TACE+MVA治疗），比较两组患者的客观缓解率、肿瘤标志物[甲胎蛋白（AFP）、糖类抗原19-9(CA19-9)]水平、血管内皮生长因子（VEGF）水平，肝功能指标[总胆红素（TB）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）]，分析两组患者术后不良反应发生情况。结果 联合组患者客观缓解率高于TACE组患者，差异有统计学意义（P<0.05）。治疗后，联合组患者AFP、VEGF、CA19-9、TB、ALT、AST水平均低于TACE组患者，差异均有统计学意义（P<0.05）。两组患者术后不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 TACE序贯MVA治疗中晚期HCC患者的近期临床疗效较好，可有效降低血清肿瘤标志物及VEGF水平，且不增加术后不良反应发生率，安全性较高，值得在临床上进一步推广应用。更多还原

【Abstract】 Objective To investigate the clinical efficacy of transcatheter arterial chemoembolization(TACE)followed by microwave ablation(MVA) in the treatment of advanced hepatocellular carcinoma(HCC). Method The clinical data of 140 patients with advanced HCC admitted to the 4th People’s Hospital of Qinghai Province from January 2019 to December 2021 were collected. They were divided into TACE group(n=51, given TACE treatment)and combined group(n=89, given TACE+MVA treatment) according to different treatment methods. The objective response rate, tumor marker levels [alpha fetoprotein(AFP), carbohydrate antigen 19-9(CA19-9)], vascular endothelial growth factor(VEGF), and liver function index levels [total bilirubin(TB), alanine aminotransferase(ALT), aspartate aminotransferase(AST)] were compared between the two groups. The adverse reactions of the two groups were also analyzed. Result The objective response rate in the combined group was higher than that in the TACE group, the difference was statistically significant(P<0.05). After the treatment, the levels of AFP, VEGF, CA19-9, TB, ALT, and AST in the combined group were lower than those in the TACE group, the differences were statistically significant(P<0.05). There was no significant difference in the total incidence of postoperative adverse reactions between the two groups(P>0.05). Conclusion The recent clinical efficacy of TACE followed by MVA in the treatment of patients with advanced HCC is reliable, and it can effectively reduce the levels of serum tumor markers and VEGF. Moreover, this method does not increase the incidence of postoperative adverse reactions, with high safety and is worthy of further clinical application.更多还原