青年人和老年人原发性肝癌的临床研究

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。

Clinical research of hepatocellular carcinoma in the elderly and young

Objective：To investigate clinicopathologic characteristies of primary hepatocellular carcinoma （PHC） in young and aged patients．Methods：We examined the characteristics of 207 consecutive patients with PHC，including 95 cases younger and 112 cases older have been compared．Results：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．Conclusion：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．