目的 探讨吡柔比星联合奥沙利铂和氟尿嘧啶治疗肝癌的临床疗效及对血清甲胎蛋白（AFP）、糖类抗原19-9（CA19-9）、血管内皮生长因子（VEGF）的影响。方法 选取2017年1月—2020年1月在商丘市第一人民医院治疗的108例原发性肝癌患者，根据患者入院时病历号末尾奇偶数分为对照组（52例）和治疗组（56例）。对照组患者给予肝动脉化疗栓塞（TACE）治疗，治疗组在对照组的基础上于肿瘤中注射40 mg/m²的注射用盐酸吡柔比星。两组均间隔3周行第2次和第3次治疗，两组患者均治疗12周。观察两组的临床疗效，比较两组治疗前后AFP、CA19-9和VEGF水平。随访比较两组的生存情况。结果 治疗后，治疗组总有效率为39.29%，显著高于对照组的21.15%（P<0.05）。治疗后，两组血清AFP、CA19-9及VEGF较治疗前显著降低（P<0.05）；治疗后，治疗组血清AFP、CA19-9及VEGF明显低于对照组（P<0.05）。治疗组中位总体生存时间明显长于对照组（P<0.05）。结论 吡柔比星联合奥沙利铂和氟尿嘧啶治疗肝癌有较好的临床效果，可以降低血清AFP、CA19-9及VEGF水平，改善患者预后，具有一定的临床推广应用价值。

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