老年原发性肝癌168例临床分析

Clinical analysis of primary hepatocellular carcinoma in elderly patients

目的通过总结老年原发性肝癌患者的临床资料,分析老年原发性肝癌的临床特点,探讨老年人肝癌合理的治疗方式。方法168例老年肝癌患者,分为外科治疗组、介入治疗组及保守治疗组,分别为57例、85例及26例。结果在所有确诊肝癌患者中,83.9%有乙肝病毒(HBV)感染史,77.4%表现为HBsAg阳性,64.9%有慢性肝炎病史,59.5%合并肝硬化或肝纤维化。外科治疗组1、2、5年生存率为84.2%、66.7%及28.1%;介入治疗组为72.9%、58.8%及10.6%;保守治疗组7.7%、3.8%、0.0%。结论HBV感染是导致老年原发性肝癌的主要原因,并呈现为无症状携带者、急慢性肝炎,肝硬化和肝癌等不同演变过程。外科手术治疗是提高患者生存率的重要方法,介入治疗同样可以取得理想效果。

Objective To analyze clinical features of primary hepatocellular carcinoma in elderly patients by summarizing clinical datas from January 2000 to December 2006. Methods 168 elderly patients diagnosed as primary hepatocellular carcinoma, 68 cases operated, 85 cases received intervention treatment and 26 cases received conservation treatment. Results 83.9% of patients infected by hepatitis virus. 77.4% of patients were HBsAg（＋）. 65.0% of patients had chronic hepatitis and 59.5% of patients had hepatic cirrhosis. The 1-,2- and 5-year survival rates in operation group were 84.2%,66.7% and 28.1% respectively, 72.9% ,58.8% and 10.6% in intervention treatment group,respectivdy,and 7.7% ,3.8% and 0.0% in conservation group. Conclusions Infected by hepatitis viruse was the mainl reason of primary hepatocellular carcinoma in elderly patients. The survival rate of elderly patients with hepatocellular carcinoma was higher with active therapy. Both operation and intervention treatment are slnilar important and effective.