发热型原发性肝癌的临床特点及预后

目的:探讨发热型肝癌的临床特点及预后。方法:收集2011年至2013年在河南中医药大学第一附属医院的原发性肝癌患者共40例，分为发热组及普通组各20例，比较两组患者的白细胞计数、中性粒细胞比率、AFP阳性率、癌性疼痛率、IL-6因子水平及远期治疗效果。结果:发热组与普通组相比存在较高的白细胞计数［(7.32±2.5）×109/L vs （4.08±1.14）×109/L，P<0.01］、中性粒细胞比率［(79.3±5.7）% vs （56.7±11.5）%，P<0.01］、AFP阳性率(100% vs 60%,P=0.04)、癌性疼痛率(60% vs 10%，P=0.03)、IL-6因子水平［(116.6±15.1） ng/ml vs (104.9±12.6) ng/ml,P<0.01］，普通组肝癌患者1、2、3年生存率分别为75%、40%及20%，发热组肝癌患者1、2、3年生存率分别为45%、10%及5%，二者的3年生存率差异有统计学意义（P=0.02）。结论:发热型肝癌存在较高的癌性疼痛率及AFP阳性率，存在白细胞增高及中性粒细胞比率增高的特点，且发热型肝癌的预后较普通型肝癌更差。

Clinical characteristics and prognosis of the fever type of hepatocellular carcinoma

Objective:To investigate the clinical characteristics and prognosis of the fever type of hepatocellular carcinoma.Methods:Clinical data of 40 patients were retrospectively analyzed.They were diagnosed with hepatocellular carcinoma and treated between 2011 and 2013 at the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.They were divided into fever group and control group.The number of white blood cells，the ratio of neutrophils，AFP positive rate，cancer pain rate，IL-6 factor level and long-term efficacies were compared between them.Results:The number of white blood cells ［(7.32±2.5)×109/L vs (4.08±1.14)×109/L,P<0.01］，the ratio of neutrophils ［(79.3±5.7)% vs (56.7±11.5)%,P<0.01］，AFP positive rate (100% vs 60%,P=0.04)，cancer pain rate (60% vs 10%,P=0.03)，IL-6 factor ［(116.6±15.1) ng/ml vs (104.9±12.6) ng/ml,P<0.01］ were higher in the fever group than the control group.The 1-,2-,3-year overall survival rates were 75%，40% and 20% in the control group，while they were 45%，10% and 5% in the fever group.There were significant differences in 3-year overall survival rates between the two groups (P=0.02).Conclusion:There is a higher rate of cancer pain and AFP positive rate in fever type of hepatocellular carcinoma，and there is a significant increase in leukocyte and neutrophil ratio in fever group，and the prognosis of the fever type of hepatocellular carcinoma is worse than control group.