无水酒精注射联合经导管肝动脉化疗栓塞与单纯无水酒精注射治疗小肝癌的疗效比较

目的 比较无水酒精注射（（percutaneous ethanol injection，PEI）联合经导管肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）与单纯PEI治疗小肝癌的疗效。方法 回顾性分析我院2008年10月至2014年12月收治的50例小肝癌患者的临床资料。50例中41例行PEI联合TACE，9例行单纯PEI。比较两组术后甲胎蛋白（alpha fetoprotein，AFP）变化及术后1年、2年、3年生存情况。结果 PEI联合TACE组术后AFP转阴率为66.67%、AFP下降率为90.48%，术后1年、2年、3年生存率分别为87.80%、80.49%和75.61%。单纯PEI组术后AFP转阴率为14.29%、AFP下降率为71.43%，术后1年、2年、3年生存率分别为77.78%、55.56%和33.34%。PEI 联合TACE组AFP转阴率、术后3 年生存率高于单纯PEI组（P<0.05）。结论 PEI联合TACE治疗小肝癌疗效优于单纯PEI，有临床应用价值。

Comparison of ethanol injection combined with transcatheter arterial chemoembolization or ethanol injection alone for treatment of small hepatocellular carcinoma

Objective To compare ethanol injection with or without transcatheter arterial chemoembolization（TACE） for treating small hepatocellular carcinoma.　Methods　Clinical data of 50 patients with small hepatocellular treated at our hospital from October 2008 to November 2014 were retrospectively analyzed.　Patients were treated with ethanol injection combined with TACE（n=41） or with ethanol injection alone（n=9）.　The two groups were compared in terms of alpha fetoprotein（AFP） negative rate，AFP decrease rate，and survival rates at 1，2，and 3 years.　Results In the combination treatment group，the AFP negative rate was 66.67%，the AFP decrease rate was 90.48%，and survival rates were 87.80% at 1 year，80.49% at 2 years and 75.61% at 3 years.　The corresponding results for the ethanol-only group were 14.29%，71.43%，77.78%，55.56% and 33.34%.The combination group showed higher AFP negative rate and higher 3-year survival rate than the ethanol-only group.　Conclusions Ethanol injection with TACE is superior to ethanol injection alone for small hepatocellular carcinoma，so it should be considered as a valuable treatment against this disease.