伴或不伴肝硬化原发性肝癌临床特点的对比分析

Analysis on Clinical Characteristics of Primary Hepatocellular Carcinoma with or Without Cirrhosis

目的 :探讨伴和不伴肝硬化的原发性肝癌的临床特点。方法 :对 2 81例伴肝硬化和 14 7例不伴肝硬化的肝癌患者的临床资料及实验室检验指标进行对比分析。结果 :与不伴肝硬化的肝癌患者相比 ,伴有肝硬化的肝癌患者起病隐匿、HBV感染率更高 (85 1%vs 6 7 3% ,P <0 0 1) ,AFP以及AST升高明显 (P <0 0 5 ) ,手术切除机会少。结论 :伴肝硬化的肝癌与HBV感染有更强的相关性 ,监测AFP对发现肝硬化癌变意义大 ,而早期B超对不伴肝硬化的肝癌诊断更为重要。

Objective: To investigate the clinical characteristics of HCC with and without liver cirrhosis. Methods: Two hundreds and eighty-one patients with cirrhosis and 147 patients without cirrhosis were studied in terms of the clinical symptoms, and signs and laboratory parametes. Results: The development of HCC with cirrhosis were more insidiously and the prevalence of HbsAg in HCC patients with cirrhosis was significantly higher than in those without cirrhosis (85.1% vs 67.3%, P<0.01), AFP and AST were elevated in more patients with cirrhosis than those without cirrhosis (P<0.05). Conclusion: The HCC with cirrhosis is more significantly associated with HBV infection than those without cirrhosis. Monitoring serum AFP is useful for cancer detection in patients with cirrhosis, however for those patients without cirrhosis, early ultrasound is more important.