300例青年病毒性肝炎、肝硬化患者的肝癌早期诊断的相关因子的临床分析

Clinical analysis on relative factors of hepatoma early diagnosis in 300 cases of youth hepatitis and liver cirrhosis

目的探讨青年慢性病毒性肝炎、肝硬化患者中肝癌早期诊断的相关因子。方法对300例年龄在18～40岁的青年病毒性肝炎、肝硬化和肝癌患者进行病史调查、辅助检查和相对危险度的比较分析。结果肝癌组的男女之比3．76：1，肝癌和病毒性肝炎患者合并肝硬化的分别为72％、63％。肝硬化和病毒性肝炎患者发生肝癌的相对危险度分别为26．78和2．27。肝癌患者AFP阳性率为68．36％，〉400ng／ml者占44．89％。HBV感染标记随肝炎-肝硬化-肝癌的发展呈递减关系。结论男性青年病毒性肝炎、肝硬化是肝癌的高危人群；肝炎的病程与反复发作及肝癌的发生密切相关；家族肝癌及其他肿瘤史在青年肝癌的发生中相对危险度较高，AFP阳性对早期诊断肝癌有重要临床价值。

Objective To investigate the factors associated with hepatoma early diagnosis in 300 cases of youth hepatitis and liver cirrhosis. Methods The case history, auxiliary examination and relative risk（RR） were done in 300 cases of youth hepatitis and liver cirrhosis aged 18 to 40 years old. Results The total proportion of male to female was 3.76 to 1. The cases of liver cancer and virus hepatitis complicated with liver cirrhosis acounted for 72 % and 63 % respectively. The RR of hepatitis and liver cirrhosis developing to hepatoma were 26.78 and 2.27 respectively. The AFP positive rate in liver cancer patients was 68.36% ;the patients with AFP above 400 ng/ml accounted for 44.89%. HBV infection marker decreased progressively with the development of hepatitis,hepatic cirrhosis and hepatoma. Coneluslon The male youth with virus hepatitis and liver cirrhosis are high-risk poputlation of liver cancer. The patients with familial hepatoma and history of other cancer have the higer rate of RR. Positive AFP has the impontant value in clinic for early diagnosis of liver cancer.