青年人肝癌24例分析

LIVER CANCER IN THE YOUNG ADULT——A REPORT OF 24 CASES

目的 分析青年人肝癌的临床和病理特点 ,探讨改善青年人肝癌疗效的途径。方法 将我科 1993年 1月至 1998年 12月收治的原发性肝癌 2 5 3例划分为年龄≤ 35岁和 >35岁的青年人组及成年人组。从男女性别比、肝癌类型 (单结节、多结节、巨块型、弥漫型 ) ,HBs Ag阳性率 ,脾大 ,腹水 ,门静脉癌栓 ,AFP≥ 40 0μg/ml,手术切除率及存活率等方面进行对比分析。结果 青年人组男女性别比为 2 3∶ 1,成年组为 7.2∶ 1;青年人组与成年人组弥漫性肝癌 (13% ,6 % ) ,HBs Ag阳性率 (88% ,46 % ) ,脾大 (6 2 .5 % ,33% ) ,腹水 (33.3% ,16 % ) ,门静脉癌栓 (46 % ,2 2 % ) ,AFP>40 0μg/ml(38% ,17% ) ,手术切除率 (2 5 % ,14% )相比较有显著性差异(P<0 .0 5 ) ;青年组仅 1例存活超过 5年 ,成年组有 5例存活超过 3年以上。结论 青年人肝癌恶性程度及背景肝病严重程度均高于成年人 ;对 HBs Ag阳性青年人 ,尤其是男性应定期检测 AFP和 B超 ,以获得早期发现。并强调术前测定肝脏储备功能。

Objective To analyse the clinical and pathological characteristics of liver cancer in young people.Methods From Janunary 1993 to December 1998 with 253 patierts 24 cases were studied and classified into two groups with age ≤35 and age >35 years old.Their clinical data including.liver cancer types,HBSAg.portal hypertesion,ascites,cancerous embolus in portal vein,AFP,resectibility rate and survival rate between the two group were studied,Results Compared with old patient,the diffuse type.HBsAg positive,portal hypertesion,ascites,cancerous embolus in portal vein,AFP≥400ng/ml,resectibility rate were higher (P<0.05)in young patient.Conclusion The liver cancer in the young patient are diagnosed later.Early detection of AFP,B-us examination in young patients,especially in young man with HBsAg positive plays a significant role in improving their treatment results.Hepatic energetic reserve assessment for young patients with liver cancer is very importamt for operation safety and prognosis.