论文部分内容阅读
目的 分析青年人肝癌的临床和病理特点 ,探讨改善青年人肝癌疗效的途径。方法 将我科 1993年 1月至 1998年 12月收治的原发性肝癌 2 5 3例划分为年龄≤ 35岁和 >35岁的青年人组及成年人组。从男女性别比、肝癌类型 (单结节、多结节、巨块型、弥漫型 ) ,HBs Ag阳性率 ,脾大 ,腹水 ,门静脉癌栓 ,AFP≥ 40 0μg/ml,手术切除率及存活率等方面进行对比分析。结果 青年人组男女性别比为 2 3∶ 1,成年组为 7.2∶ 1;青年人组与成年人组弥漫性肝癌 (13% ,6 % ) ,HBs Ag阳性率 (88% ,46 % ) ,脾大 (6 2 .5 % ,33% ) ,腹水 (33.3% ,16 % ) ,门静脉癌栓 (46 % ,2 2 % ) ,AFP>40 0μg/ml(38% ,17% ) ,手术切除率 (2 5 % ,14% )相比较有显著性差异(P<0 .0 5 ) ;青年组仅 1例存活超过 5年 ,成年组有 5例存活超过 3年以上。结论 青年人肝癌恶性程度及背景肝病严重程度均高于成年人 ;对 HBs Ag阳性青年人 ,尤其是男性应定期检测 AFP和 B超 ,以获得早期发现。并强调术前测定肝脏储备功能。
Objective To analyze the clinical and pathological features of young patients with liver cancer, and explore ways to improve the efficacy of liver cancer in young people. METHODS: Two hundred fifty-five cases of primary liver cancer admitted to our department from January 1993 to December 1998 were divided into young people aged 35 years and younger than 35 and adults. From male to female sex ratio, liver cancer type (single nodule, multiple nodule, massive type, diffuse type), HBsAg positive rate, splenomegaly, ascites, portal vein tumor thrombus, AFP ≥ 40 0μg/ml, surgical resection rate and survival Comparative analysis of rates and other aspects. Results The ratio of male to female in the young group was 2 3: 1, the adult group was 7.2: 1; diffuse liver cancer (13%, 6 %) was found in the young group and adult group, and the positive rate of HBsAg was 88% (46%). Splenomegaly (6 2.5%, 33%), ascites (33.3%, 16%), portal vein tumor thrombus (46%, 22%), AFP> 40 0μg/ml (38%, 17%), surgical resection The rates (25%, 14%) were significantly different (P<0.05); only 1 case in the young group survived more than 5 years, and 5 cases in the adult group survived more than 3 years. Conclusions The degree of malignancy of liver cancer and the severity of background liver disease in young people are higher than those in adults. Young people with HBsAg positive, especially men, should regularly test AFP and B ultrasound to obtain early detection. And emphasize the preoperative determination of liver reserve function.