青年及老年原发性肝癌的临床分析

Clinical Study of Primary Hepatoma in the Elder and Young

目的 :探讨青年及老年人原发性肝癌的临床特点。方法 :对 95例年龄≤ 3 9岁的青年肝癌和 112例年龄≥ 60岁的老年肝癌患者进行临床分析。结果 :(1)青年组HBV感染率为 92 .63 % ,其中HBsAg(+ )为 84.2 1% ,明显高于老年组的 62 .5 0 % ,P <0 .0 1。 (2 )青年组合并肝硬化者达 72 .63 % ,高于老年组的 5 4.46% ,P <0 .0 1。 (3 )青年组肝区疼痛症状明显高于老年组 ,前者以弥散型和巨块型多见 ,而后者则以单个局限为主。 (4)青年组甲胎蛋白 [AFP(+ ) ]为 67.3 7% ,老年组为 46.43 % ,P <0 .0 5。 (5 )老年组AKP、γ GT明显高于青年组 ,心脑血管合并症亦多于青年组 ,P <0 .0 1。结论 :青年肝硬化患者是原发性肝癌最重要的高危因素 ,应对这些患者长期追踪观察以早期发现和诊断。老年肝病患者AFP阳性率低 ,当其出现AKP、γ GT值升高时 ,应高度警惕肝癌。

Objective To compare the clinical characteristics of primary hepatoma in young and aged patients.Methods 207 patients with primary hepatoma,including 95 cases younger than 39 years (young group) and 112 cases older than 60 years (aged group) were retrospectively analysed.Results (1)HBV infection rate was 92.63% in the young group. HBsAg positive rate was higher in the young group(84.21%) than that of the aged groups(62.50%)( P <0.01).(2)72.63% and 54.46% patients were superimposed with cirrhosis in young and aged groups respectively.It also showed significant difference ( P <0.01).(3) Compared with aged group, young group frequently occurred liver pain symptom.(4)AFP positive rates were 67.37% and 46.43% in young and aged group ( P <0.05).(5)Serum AKP and γ GT levels in aged group were much higher than those of the young group,and the incidence rate of cardiovascular complication in aged group was also higher than the young group( P <0.01).Conclusion With cirrhosis was the most important risk factor for primary hepatoma occuring in the young.We should give a long term observation as to earlier diagnose in these patients.When serums AKP and γ GT levels increased obviously in the elder,we must be cautious about it.