青年人和老年人原发性肝癌的临床研究

Clinical research of hepatocellular carcinoma in the elderly and young

目的 :为提高原发性肝癌 ( PHC)诊断和防治水平 ,分析青年和老年 PHC的临床和病理特点。方法 :对 95例青年 PHC和 112例老年 PHC进行了临床比较。结果 :1两组 PHC男女之比 ,青年组 4∶ 1,老年组 4 .4∶ 1;2两组临床症状、体征方面 :青年组肝区痛及脾大明显 P<0 .0 1,P<0 .0 5;3老年 PHC以单个局限型为主 ,青年以弥漫型为主 ;4青年组 AFP( +)占 67.37% ,>30 0 ng/ ml占4 1.5% ,老年组 AFP( +)占 4 6.4 3% ,>30 0 ng/ ml占 2 6.79% .肝功能异常老年组明显 P<0 .0 1或0 .0 5;5HBVM( +)青年组占 92 .63% ,HBs Ag( +) 84 .2 1% ;老年组分别为 79.4 6% ,62 .50 %。结论 :青年人 PHC恶性程度高 ,对 HBs Ag( +)青年男性定期检测 AFP和 B超 ,有助于早期诊断。

Objective:To investigate clinicopathologic characteristies of primary hepatocellular carcinoma (PHC) in young and aged patients.[WT5HZ]Methods:[WT5BZ]We examined the characteristics of 207 consecutive patients with PHC,including 95 cases younger and 112 cases older have been compared.[WT5HZ]Results:[WT5BZ]The results showed:The hepatocellular carcinoma was more common in males than in females (the ratio of males for females is 4∶1 and 4,4∶1 in young group and older group)②It is significant distinctness that the liver pain and spleen swell are common in young group.③The main form of hepatic tumors is solitary and massive in older group and is diffuse multiple in young group.④An elevation of serum alpha fetoprotein (AFP) was more frequent in young group.But the elevation of ALT was more significant in older group (P<0.01 or 0.05).⑤Young group had a greater prevalence of the hepatitis B surface antigen (HBsAg) carriers and positive of hepatitis B virus markers.[WT5HZ]Conclusion:[WT5BZ]An early exposure to the virus and /or an accelerated hepatocarcinogenesis in HBsAg carriers can be inferred.It is necessary that young male HBsAg carriers must be tested in regular time with AFP and ultrasonic B.