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目的 探讨腹腔镜对影像学检查阴性肝癌的诊断价值。 方法 对42例临床怀疑肝癌而超声波检查、CT扫描和肝脏数字减影均阴性的患者做腹腔镜检查,使用A5201和国产QJF腹腔镜。 结果 病理证实原发性肝细胞癌6例,转移性肝癌1例。镜下特点为肝脏弥漫性肿大,表面有糜烂或<1cm结节或溃疡,另1例腹腔镜诊断慢性迁延性肝炎,6个月后发现肝占位病变,B超引导下穿刺活检证实肝细胞癌。 结论 现代影像学不能完全取代腹腔镜检查,二者各有优势和缺陷,必须互相补充才能提高肝癌诊断水平。对二者均阴性而临床怀疑肝癌的患者应严密随访。
Objective To explore the diagnostic value of laparoscopy in imaging-negative liver cancer. Methods Laparoscopy was performed on 42 patients with clinically suspected hepatocellular carcinoma who were negative for ultrasound, CT scan, and digital liver subtraction. A5201 and domestic QJF laparoscopy were used. Results Pathology confirmed 6 cases of primary hepatocellular carcinoma and 1 case of metastatic liver cancer. Microscopically, the liver is characterized by diffuse enlargement of the liver, erosion or <1cm nodule or ulceration on the surface, another case of chronic persistent hepatitis diagnosed by laparoscopy, hepatic mass lesions found after 6 months, and biopsy under the guidance of a B-ultrasound to confirm the liver. Cell cancer. Conclusion Modern imaging cannot completely replace laparoscopy. Both have their own advantages and disadvantages. They must complement each other to improve the diagnosis of liver cancer. Patients who are both negative and have clinical suspicion of liver cancer should be closely followed up.