原发性肝癌177例临床分析

    Clinical analysis of 177 cases of primary liver cancer

    • 摘要: 目的:探讨原发性肝癌(PLC)病因及临床特点。方法:对177例PLC患者的年龄、性别、症状、病原学、肝功能、甲胎蛋白(AFP)及影像学检查结果进行回顾性分析。结果:177例PLC患者中,发病年龄高峰为40~60岁,男女发病率之比为3.43∶1,乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)的感染率分别为75.14%和0.56%,-谷酰基转肽酶(-GGT)和AFP阳性率分别为73.45%和74.58%,门静脉癌栓率41.81%,远处转移率0.56%。手术治疗78例,其中肝细胞型肝癌(HCC)68例,肝内胆管细胞型肝癌(ICC)10例,前者HBV感染率(76.47%)高于后者(10.00%)(P0.05),而总胆红素和碱性磷酸酶的阳性率分别为14.71%、50.00%和17.65%、60.00%,差异有统计学意义(P0.05)。结论:PLC危险因素包括40岁以上、男性、HBV感染;-GGT和AFP或许有助于PLC的诊断;PLC转移以肝内血行转移多见;PLC细胞分型以HCC多见;ICC患者碱性磷酶阳性率较高,可能有助于诊断。

       

      Abstract: Objective:To study the etiology and clinical features of primary liver cancers(PLC).Methods:The age,gender,symptoms,liver function, fetoprotein(AFP) and imaging results of 177 patients with primary liver cancers were analyzed retrospectively.Results:The peak age of PLC was 40-60.The morbility of male and female was 3.43∶ 1.The infection rates of HBV and HCV were 75.14% and 0.56%,respectively.The positive rates of -glutamyl transferase(-GGT) and AFP were 73.45% and 74.58%,respectively.The rate of portal vein thrombosis and distant metastases were about 41.81% and 0.56%,respectively.Seventy-eight of the cases received surgical therapy.Among the 78 cases,68 were confirmed to be hepatocellular carcinoma(HCC) and 10 intrahepatic cholangiocarcinoma(ICC).The infection rate of HBV of the former(76.47%) was higher than that of the latter(10.00%)(P0.05);the positive rates of total bilirubin and alkaline phosphatase were 14.71% and 50.00% versus 17.65% and 60.00%(P0.05).Conclusions:The risk factors for PLC include ages above 40,male and infection of HBV.-GGT and AFP may be beneficial to the diagnosis of PLC.The most common metastasis of PLC is innerliver hematogenous metastasis.HCC is often observed in PLC.ICC patients usually have a high positive rate of alkaline phosphatase,which may be of help to the diagnosis of intrahepatic cholangiocarcinoma.

       

    /

    返回文章
    返回