老年原发性肝癌临床特点对照分析

目的探讨病理类型、年龄、性别、肝病背景及AFP等因素与老年原发性肝癌发生的相关关系。方法对2005年1月～2008年7月住院128例原发性肝癌患者(其中老年组60例,非老年组68例)进行回顾性分析,比较两组患者的一般情况、病理特点、AFP情况及术前肝功能情况。结果两组患者HBsAg(+)阳性率比较差异显著(P<0.05);合并症老年组明显高于非老年组(P<0.05);肝硬化体征老年组则明显低于非老年组(P<0.05)。老年组肝癌病人多以结节型多见,而非老年组则以弥漫型多见。老年组以EdmondsonⅠ～Ⅱ级多见,而非老年组则以Ⅲ～Ⅳ居多;老年组患者术前肝功能各项指标均明显高于非老年组患者(P<0.05);AFP比较,非老年组肝癌术前AFP(+)率及定量≥400ng/ml的患者明显高于老年组。结论老年原发性肝癌在临床表现、病理特征等各方面都差异于一般人群,AFP对诊断老年原发性肝癌的临床价值大。

Objective To explore relationship of pathological type, age, sex, background of liver disease and AFP influence factors for primary hepatic carcinoma in the old patients.Methods Review and analyse128 patients in hospital with primary hepatic carcinoma（60 in aged group,68 in young group）from January 2005 to July 2008.General state of health, patho-characteristic, AFP and hepatic function preoperation of the patients were compared.Results There were significant difference in HBsAg positive rates between the two groups（P〈0.05）;The complication in aged group were significantly higher than young group（P〈0.05）; The hepatic cirrhosis in aged group were significantly lower than young group（P〈0.05）. The patho-characteristic were nodes and giant mass type in aged group while suffusion and giant mass type in young group.The majority was in Edmondson Ⅰ - Ⅱ in aged group,but which was in Edmondson Ⅲ - Ⅳ in young group; Preoperative hepatic function in aged group were significantly higher than young group（P〈0.05）; AFP positive rates and quantitation equal to or exceed 400ng/ml in young group were significantly higher than aged group.Conclusion There were difference in clinical manifestation, patho-characteristic of primary hepatic carcinoma between the aged group and the general group, AFP is significant for hepatocellular carcinoma ,which is one of the best forepart diagnose now.