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目的 探索防治肝癌术后复发的有效方法。方法 对我院原发性肝癌进行皮下植入式药泵肝动脉门静脉化疗栓塞对防治肝癌术后复发的前瞻性临床研究。研究对象 10 3例 ,随机分治疗组 (肝切除 +皮下泵肝动脉、门静脉化疗栓塞 ) 5 2例 ,对照组 (单纯肝切除 ) 5 1例。结果 治疗组和对照组术后 1、3、5年复发率分别为13 5 %、4 6 2 %、67 3%和 19 6%、60 8%、86 2 % ,两组差异有显著性 (P <0 0 5 )。治疗组和对照组术后 1、3、5年生存率分别为 88 35 %、62 69%、32 4 6%和 80 4 %、4 4 93%、2 0 2 % ,两组间有显著性差异 (P <0 0 5 )。结论 ⑴根据我们的临床观察 ,术前AFP定量与预后成相关性 ,尤其AFP >30 0 0 μg/L者预后差 ,术前AFP阴性者 ,疗效优于阳性者。⑵肝癌术后复发是影响肝癌远疗效的主要因素。本组资料显示治疗组术后复发率明显降低 ,无瘤生存期延长 ,生存率明显提高。肝动脉门静脉化疗栓塞对防治肝癌复发有明确的价值。
Objective To explore effective methods for prevention and treatment of recurrence of liver cancer. Methods A prospective clinical study on the prevention and treatment of liver cancer recurrence after hepatic artery portal vein chemoembolization was performed on primary liver cancer in our hospital. The study subjects were 103 patients randomly assigned to the treatment group (hepatectomy + subcutaneous pump hepatic artery, portal vein chemoembolization) in 52 patients and the control group (simple hepatectomy) in 51 patients. Results The recurrence rates of the treatment group and control group at 1, 3, and 5 years after surgery were respectively 135%, 46.2%, 67%, 196%, 608%, and 86%. There was a significant difference between the two groups ( P <0 0 5 ). The 1-, 3-, and 5-year survival rates of the treatment and control groups were respectively 88.5%, 62.69%, 32.6% and 84.4%, 4.93%, and 2.02%. There was significant difference between the two groups. Difference (P < 0 0 5). Conclusions (1) According to our clinical observations, preoperative AFP quantification correlates with prognosis, especially those with AFP >300 μg/L have a poor prognosis, and those with preoperative AFP negative have better efficacy than those with positive AFP. (2) The recurrence of hepatocellular carcinoma is the main factor affecting the long-term efficacy of hepatic cancer. The data in this group showed that the recurrence rate was significantly reduced in the treatment group, the tumor-free survival period was prolonged, and the survival rate was significantly improved. Hepatic arterial portal vein chemoembolization is of definite value in preventing and treating the recurrence of liver cancer.