目的 探討吡柔比星聯(lián)合奧沙利鉑和氟尿嘧啶治療肝癌的臨床療效及對(duì)血清甲胎蛋白（AFP）、糖類抗原19-9（CA19-9）、血管內(nèi)皮生長因子（VEGF）的影響。方法 選取2017年1月—2020年1月在商丘市第一人民醫(yī)院治療的108例原發(fā)性肝癌患者，根據(jù)患者入院時(shí)病歷號(hào)末尾奇偶數(shù)分為對(duì)照組（52例）和治療組（56例）。對(duì)照組患者給予肝動(dòng)脈化療栓塞（TACE）治療，治療組在對(duì)照組的基礎(chǔ)上于腫瘤中注射40 mg/m²的注射用鹽酸吡柔比星。兩組均間隔3周行第2次和第3次治療，兩組患者均治療12周。觀察兩組的臨床療效，比較兩組治療前后AFP、CA19-9和VEGF水平。隨訪比較兩組的生存情況。結(jié)果 治療后，治療組總有效率為39.29%，顯著高于對(duì)照組的21.15%（P<0.05）。治療后，兩組血清AFP、CA19-9及VEGF較治療前顯著降低（P<0.05）；治療后，治療組血清AFP、CA19-9及VEGF明顯低于對(duì)照組（P<0.05）。治療組中位總體生存時(shí)間明顯長于對(duì)照組（P<0.05）。結(jié)論 吡柔比星聯(lián)合奧沙利鉑和氟尿嘧啶治療肝癌有較好的臨床效果，可以降低血清AFP、CA19-9及VEGF水平，改善患者預(yù)后，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of pirubinacin combined with oxaliplatin and fluorouracil in treatment of primary liver cancer and its effect on serum levels of AFP, CA19-9, and VEGF.Methods A total of 108 patients with primary liver cancer treated in the First People's Hospital of Shangqiu from January 2017 to January 2020 were selected and divided into control group (52 cases) and treatment group (56 cases) according to the odd-even number at the end of medical record number at admission. Patients in the control group were treated with TACE. Patients in the treatment group were additively injected 40 mg/m² of Pirarubicin Hydrochloride for injection into the tumor. Both groups received the second and third treatments at an interval of 3 weeks, and patients in both groups were treated for 12 weeks. The clinical efficacy of the two groups was observed, and the levels of AFP, CA19-9, and VEGF were compared before and after treatment. Follow-up was used to compare the survival of the two groups.Results After treatment, the total effective rate of the treatment group was 39.29%, which was significantly higher than that of the control group (21.15%,P<0.05). After treatment, the serum AFP, CA19-9, and VEGF in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the levels of AFP, CA19-9, and VEGF in treatment group were significantly lower than those in control group (P<0.05). The median overall survival time in treatment group was significantly longer than that in control group (P<0.05).Conclusion Pirubicin combined with oxaliplatin and fluorouracil has a good clinical effect in the treatment of liver cancer, and can reduce the levels of serum AFP, CA19-9 and VEGF, improve the prognosis of patients, which has a certain clinical application value.

R979.1