肝硬化背景胆管细胞癌的MSCT影像诊断及实验室检查分析

MSCT diagnosis and clinical laboratory tests analysis of ICC in HBV-associated cirrhosis

目的:探讨乙肝相关性肝硬化背景下ICC影像及实验室检查特征,以期提高对ICC的诊断水平。方法:将49例经病理证实的ICC患者进行分组:①非肝硬化组(N组)40例,乙肝相关性肝硬化组(C组)9例,对两组MSCT征象及实验室检查进行比较;②乙肝阳性组(HbsAg+)24例,乙肝阴性组(HbsAg-)25例,对AFP、Ca-199、肝内胆管结石3指标进行比较。使用SPSS 11.5统计软件,检验水准ɑ=0.05。结果:N、C两组ICC的MSCT影像表现及实验室检查之间比较统计学上无显著差异。HbsAg+组ICC 1例合并肝内胆管结石,HbsAg-组9例,差别有统计学意义(P=0.016)。HbsAg+组10例AFP指标阳性,HbsAg-组3例,差别有统计学意义(P=0.019);HbsAg+组7例Ca-199指标阳性、HbsAg-组15例阳性,差别有统计学意义(P=0.03)。结论:乙肝相关性肝硬化下ICC与非肝硬化下ICC在MSCT影像表现上无特殊,乙肝相关性肝硬化下ICC常可有血清AFP的升高。只有熟悉ICC的影像表现,才能减少肝硬化背景ICC的误诊。

Objective：To evaluate the MSCT findings and clinical laboratory tests in patients with ICC from cirrhosis with HBV. Methods..49 cases of ICC was divided into 4 groups, （1） noncirrhotic group （n=40）, cirrhotic group （n=9）, then the MSCT findings and laboratory tests were compared respectively at each group （2） HBV antigen positive group （n= 24）, HBV antigen negative group （n= 25）, the laboratory tests and hepatolithiasis were compared respectively＇at each group as well. Statistic analysis was conducted on Spss11.5, size of test a=0.05. Results：There was no statistical significance on the MSCT findings and laboratory tests between the noncirrhotic and cirrhotic group. 1 case with hepatolithiasis was detected in HBV antigen positive group while 9 cases in HBV antigen negative group, P =0. 016; serum AFP was elevated in 10 cases in HBV antigen positive group compared with 3 cases in HBV antigen negative group, P =0. 019; elevated serum Ca-199 was found in 7 cases in HBV antigen positive group and 9 cases seen in negative group, P = 0.03. Conclusion： There was no significant difference on MSCT findings of ICC in HBV-associated cirrhotic liver, the same as in the noncirrhosis. The elevated level of serum AFP showed always in HBV-associated cirrhosis.