小肝癌的诊断与治疗

The experiense of dignosis and resection in little hepatic carcinoma

目的 :总结 5 4例小肝癌的诊断与手术切除经验。方法 :回顾性分析了近 10a来收治经病理证实的 5 4例小肝癌的诊断与手术治疗情况。其中无症状体检或因其他疾病检查B超、CT发现 2 9例 (5 3 7% ) ,AFP >2 0 μg/L占 46 2 %。 5 4例均行非规则性肝切除 ,其中肝局部切除 36例 ,肝段切除 8例 ,肝叶切除 6例 ,肝切除 +脾切除 +断流术 4例 ,肝叶切除 +门静脉取栓术 3例 ,术后复发再切除 5例。结果 :5 4例小肝癌术后 1、3、5a生存率分别为 98 1%、74 6 %、6 0 2 %。术后 2a复发率为 2 7 3%。结论 :AFP、B超是发现小肝癌的首选方法 。

Objective To summarize the experiens of diagnosis and resection in 54 cases little hepatic carcinoma.Method 54 cases of little hepatic carcinoma resected in the last 10 years were viewed.29 cases (53 7%) proved by B-us or CT were asymptomatic or other diseases.AFP was positive (>20μg/L) in 25 cases.All patients underwent irregular hepatectomy.Surgical proceduce included focus resection (36 cases),segmental resection (8 cases),hepatolobectomy (6 cases),hepatolobectomy plus splenectomy and devascularization (4 cases),hepatolobectomy plus the cleareance of tumor thrombi from portal (3 cases),recurrent carcinoma were resected (5 cases).Results Survival rate at 1?3?5 years was 98 1%?74 6%?60 2%.Recurrent rate at 2 years was 27 3%.Conclusion AFP an B-us is the best way to select HCC.Hepatolobectomy is an effective treasure for HCC.