青年原发性肝癌的临床特点分析及其预防手段的探讨

Analysis of the clinic feature and prevent device of primary liver carcinoma(PLC) in youth

目的探讨青年原发性肝癌(PLC)的临床特征。方法随机选择2010年以前有随访的PLC患者120例,并按年龄随机分为青年肝癌组(年龄<40岁)32例,非青年肝癌组(年龄≥40岁)88例,比较分析两组的临床症状、肝脏功能、肝癌大体类型、病理类型、HBV-DNA水平、AFP水平、手术切除率、术后并发症发生率、术后生存期。结果青年组缺乏特异性临床表现的比例较非青年组高(P<0.05);巨块型肝癌或弥漫性肝癌较非青年组青年组多(P<0.01);肝癌破裂出血的发生率较非青年组高(P<0.01);肝脏功能较老年组好(P<0.01);HBV-DNA水平较非青年组高(P<0.01);AFP水平较非青年组高(P<0.01);手术切除率较非青年组低(P<0.05);术后并发症发生率较非青年组低(P<0.05);术后生存期较非青年组短(P<0.05);胆管细胞癌比例较非青年组低(P<0.05)。结论 (1)青年人肝癌起病隐匿,发展迅速,早期诊断率低,手术切除率低,手术后生存率低。(2)PLC病情与HBV-DNA水平密切相关。(3)PLC患者AFP水平明显较高。(4)PLC中胆管细胞癌的发生率低。

Objective To investigate the clinic feature of PLC in youth. Methods 120 follow-up patients with PLC were ran- dom selected before 2010,32 patients in youth PLC group and 88 patients in non-youth group. The clinic symptom ,liver function, general type of carcinoma, phatho-type, HBV-DNA level, AFP level, exairesis rate,incidence of postoperative complications and postoperative life span was compared and analysised. Results The clinic symptom（P〈0.OS）,liver function（P〈0.O1）,general type of carcinoma（P〈0.01）, phatho-type（P〈0.01）, HBV-DNA level（P〈0.01）, AFP level（P〈O.01）, exairesis rate（P〈0.05）,incidence of postop- erative complications（P〈0.05）,postoperative life span （P〈O.05） , and the ration of holangiocellular carcinoma（P〈0.05） were all sig- nificant difference between the two groups. Conclusion The PLC in youth has obvious clinic features ：delitescence onset ,develop- ment fastness, lower ration of early diagnosis and exairesis rate, lower incidence of postoperative complications,intimate with HBV- DNA level and AFP level,lower incidence of holangiocellular carcinoma.