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原发性肝癌的早期诊断 |
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王志亮 李国威
【摘 要】 目的 探讨、分析肝硬化等诸因素在原发性肝细胞癌诊断中的价值。方法 回顾性研究肝脏其它占位性病变与原发性肝癌的临床特征，并结合近期文 献进行分析。结果 小肝癌(直径≤5cm)21例，占原发性肝癌的8.50%，均无明 显临床表现，术前确诊14例(66.67%)，合并肝硬化者20例(95.24%)；大肝癌226例，均有 临床表现，术前确诊223例(98.67%)，合并肝硬化者199例(88.05%)；其它肝占位性病变13 1例，合并肝硬化1例(0.76%)。上述比率经两样本率比较的u检验统计学处理，均有显 著性差 异。结论 原发性肝细胞癌早期症状隐匿，均为偶尔体检或因有肝炎病史随诊时 发现，术前早期确诊率低。合理联用AFP，肝硬化及多种影象检查，可望提高诊断水平。特 别对AFP阴性的、有疑问的占位性病变，合并肝硬化有特殊的确诊价值。
【关键词】 原发性肝细胞癌 复发性肝细胞癌 肝硬化 早期诊断
Early diagnosis of primary hepatocellular carcinoma
Wang Zhiliang，Li Guow ei
(Department of General Surgery，The Second Affiliated Hospital，Xi'an Medica l University，Xi'an 710004)
【Abstract】 Objective To explore and investigate the value of the cirrh osis and other factors in the diagnosis of primary hepatocellular carcinom a(Hcc).Metho ds We retrospectively analyzed clinical characteristics of primary hepato cellu lar carcinoma and other hepatic occupied diseases and then combined with the rec en t references.Results All 21 cases of small Hcc (8.50% in Hcc) had not distinct clinical presentation，14 cases (66.67%) were diagnosed preoperatively ，20 cases (95.24%) with cirrhosis；all of 226 cases of large Hcc had disti nct clinical presentation，223 cases (98.67%) were diagnosed preoperatively，19 9 cases (88.05%) with cirrhosis；other hepatic occupied diseases were 131 c a ses，only one case with cirrhosis (0.76%).All the data were statistically analy zed (U test within low ratio) and the significant difference was found.C onclusion The early symptoms of Hcc are so insidious that this diseas e is often det ected by random examination or keeping watch on patients with history of hepatit is.So，the rate of diagnosis of Hcc may be enhanced through rational combination with AFP and cirrhosis and sorts of imaging means.In patients with negative AFP ，dubious occupied diseases，cirrhosis may have special value for diagnosis of Hcc.
【Key words】 Primary hepatocellular carcinoma Recurrent hepa[1] [2] 下一页
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