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摘要：
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摘要：目的 探讨无水乙醇经皮穿刺（percutaneous ethanol injection，PEI）联合肝动脉化疗栓塞
（transcatheter arterial chemoembolization，TACE）治疗原发性肝癌的临床疗效。方法 选取2016年4月至
2019年4月上海交通大学医学院附属仁济医院收治的82例原发性肝癌患者为研究对象，采用随机数
字表法分为观察组和对照组，每组41例。对照组给予TACE治疗，观察组在此基础上联合PEI治疗，
比较两组患者的肝功能 [包括丙氨酸氨基转移酶（alanine aminotransferase，ALT）、天门冬氨酸氨
基转移酶（aspartate aminotransferase，AST）和总胆红素（total bilirubin，TBil）]、肿瘤标志物 [甲
胎蛋白（alpha-fetoprotein，AFP）、癌胚抗原（carcinoembryonic antigen，CEA）和糖类抗原199
（carbohydrate antigen 199，CA199）]、临床疗效 [客观缓解率（objective response rate，ORR）和疾
病控制率（disease control rate，DCR）]及不良反应。结果 治疗后，观察组和对照组患者ALT [观察
组：（41.34 ± 6.09）U/L vs（89.12 ± 9.45）U/L；对照组：（47.23 ± 6.67）U/L vs（87.87 ± 9.39）U/L]、
AST [观察组：（48.98 ± 8.98）U/L vs（98.35 ± 10.12）U/L；对照组：（57.19 ± 8.19）U/L vs（99.30 ±
10.23）U/L]和TBil [观察组：（31.80 ± 4.89）μmol/L vs（51.34 ± 6.28）μmol/L；对照组：（38.03 ±
5.02）μmol/L vs（52.20 ± 6.01）μmol/L]水平均显著低于治疗前，且观察组患者上述指标均显著低于
对照组，差异均有统计学意义（P均＜ 0.05）。治疗后，观察组和对照组患者AFP [观察组：（129.23 ±
15.80）μg/L vs（622.31 ± 52.35）μg/L；对照组：（144.45 ± 16.22）μg/L vs（631.09 ± 53.98）μg/L]、
CEA [观察组：（5.12 ± 2.19）mg/L vs（12.29 ± 3.12）mg/L；对照组：（7.87 ± 2.86）mg/L vs（11.47 ±
3.23）mg/L]和CA199 [观察组：（29.35 ± 5.22）U/L vs（89.54 ± 11.35）U/L；对照组：（34.32 ± 5.76）U/L vs
（91.25 ± 12.15）U/L]水平均显著低于治疗前，且观察组患者上述指标均显著低于对照组，差异均
有统计学意义（P均＜ 0.05）。治疗后，观察组患者ORR [69.29%（28/41）vs 46.34%（19/41）]和
DCR [78.05%（32/41）vs 56.10%（23/41）]均显著高于对照组，差异有统计学意义（χ 2 = 4.038，P =
0.044；χ 2 = 4.473，P = 0.034）。治疗期间观察组和对照组不良反应发生率分别为19.51%（8/41）、
12.20%（5/41），差异无统计学意义（χ 2 = 0.823，P = 0.364）。结论 PEI联合TACE治疗原发性肝癌
的疗效显著，可提高患者ORR和DCR，改善患者肝功能，降低患者肿瘤标志物水平，治疗安全性良
好，值得临床推广。
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Abstract: Objective To investigate the clinical efficacy of percutaneous ethanol injection (PEI) combined
with transcatheter arterial chemoembolization (TACE) in treatment of primary liver cancer. Methods A
total of 82 cases with primary liver cancer treated in Renji Hospital, Shanghai Jiaotong University School
of Medicine from April 2016 to April 2019 were selected and divided into observation group and control
group according to random number table method, 41 cases in each group. Patients in control group were
treated with TACE and the patients in observation group were treated with PEI on this basis. Liver function
[alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil)], tumor marker
[alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199)], clinical
efficacy [objective response rate (ORR) and disease control rate (DCR)] and adverse reactions of patients in
two groups before and after treatment were compared. Results After treatment, the ALT [observation group:
(41.34 ± 6.09) U/L vs (89.12 ± 9.45) U/L; control group: (47.23 ± 6.67) U/L vs (87.87 ± 9.39) U/L], AST [observation
group: (48.98 ± 8.98) U/L vs (98.35 ± 10.12) U/L; control group: (57.19 ± 8.19) U/L vs (99.30 ± 10.23) U/L] and TBil
[observation group: (31.80 ± 4.89) μmol/L vs (51.34 ± 6.28) μmol/L; control group: (38.03 ± 5.02) μmol/L
vs (52.20 ± 6.01) μmol/L] levels of patients in observation group and control group were significantly lower
than those before treatment, and the above indexes of patients in observation group were significantly lower
than those of control group, the differences were statistically significant (all P ＜ 0.05). After treatment, the
AFP [observation group: (129.23 ± 15.80) μg/L vs (622.31 ± 52.35) μg/L; control group: (144.45 ±
16.22) μg/L vs (631.09 ± 53.98) μg/L], CEA [observation group: (5.12 ± 2.19) mg/L vs (12.29 ± 3.12) mg/L;
control group: (7.87 ± 2.86) mg/L vs (11.47 ± 3.23) mg/L] and CA199 [observation group: (29.35 ± 5.22) U/L vs (89.54 ±
11.35) U/L; control group: (34.32 ± 5.76) U/L vs (91.25 ± 12.15) U/L] levels of patients in observation group
and control group were significantly lower than those before treatment, and the above indexes of patients
in observation group were significantly lower than those of control group, the differences were statistically
significant (all P ＜ 0.05). After treatment, the ORR [69.29% (28/41) vs 46.34% (19/41)] and DCR [78.05%
(32/41) vs 56.10% (23/41)] of the patients in observation group were significantly higher than those of
control group, the differences were statistically significant (χ 2 = 4.038, P = 0.044; χ 2 = 4.473, P = 0.034).
The incidence of adverse reactions of patients in observation group and control group were 19.51% (8/41)
and 12.20% (5/41), respectively. The difference was not statistically significant (χ 2 = 0.823, P = 0.364).
Conclusions PEI combined with TACE has a significant effect on the treatment of primary liver cancer,
which can improve the ORR, DCR and liver function and reduce the tumor marker level of the patients. The
treatment is safe and worthy of clinical promotion.
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