140例肝癌的临床特点分析

目的通过对140例肝癌临床特点的分析,了解AFP阳性肝癌和AFP阴性肝癌的各自特点。方法对10年间(1998～2007)140例肝癌(其中AFP阴性38例,AFP阳性102例),在性别、临床特点、合并症(乙型肝炎和(或)肝硬化)及γ-谷氨酰转移酶(γ-GT)方面进行对比分析。结果AFP阴性肝癌患者消瘦乏力、腹痛、腹部肿块的症状少于AFP阳性肝癌患者(分别为52.6%vs82.4%,55.3%vs75.5%,13.2%vs45.1%,P<0.05),合并乙型肝炎与AFP阳性肝癌少(68.4%vs93.1%,P<0.05);AFP阴性肝癌患者中γ-GT异常者的比例少于AFP阳性肝癌患者(63.2%vs84.5%,P<0.05),两组患者在黄疸、肝硬化、腹水方面无显著性差异。结论AFP阴性肝癌患者临床表现较轻且缺乏特异性,易于漏诊,诊断依赖于多种影像学检查和病理学检查,在临床上应予以高度重视。

Objective to understand characteristics of AFP positive liver and AFP negative liver cancer Through the analysis of clinical features of 140 cases with liver cancer Methods For a period of 10 years （1998-2007） 140 patients with hepatocellular carcinoma （negative 38 cases of AFP, AFP positive 102 cases）, sex, clinical features, complications （hepatitis B and （or） cirrhosis） and γ -glutamyl transferase （ γ -GT） were analyzed and compared. Results AFP negative patients with hepatocellular carcinoma＇ symptoms of wasting fatigue, abdominal pain, abdominal mass AFP were less than positive symptoms in patients with hepatocellular carcinoma （82.4% to 52.6%, 55.3% to 75.5%, 13.2% to 45.1%, P〈 0.05）, with hepatitis B and liver cancer was less than positive AFP （68.4% to 93.1%, P〈0.05）;the propotion of abnormal γ -GT in patients with hepatocellular carcinoma AFP negative was less than the patients with hepatocellular carcinoma （63.2% to 84.5%, P〈0.05）, two in patients with jaundice, cirrhosis of the liver, ascites regard there was no significant difference. Conclusion Clinical manifestations of AFP negative patients with hepatocellular carcinoma are low and lack of specific lighter and easy to misdiagnosis, the diagnosis relies on a variety of imaging examination and histopathological examination, clinical should pay serious attention.