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本文对62例瘤体直径在5厘米以下小肝癌进行术后AFP转归和肝病背景关系的分析,结果表明,术后AFP持续阴性者生存率,肝癌复发率与低持阳组及持续阳性组比较有明显差异(P<0.01);术后AFP转归与肝病背景,特别是与肝硬化及硬化程度是有密切关系的。从术后低持阳到肝癌复发症状出现,大约一年左右。中位数为10.5月;62例中癌周肝硬化为66.1％(41/62),其中3/5为中重度肝硬化;肝细胞不典型增生77.4％(48/82),在中重度硬化中达100％。成为肝癌发生或复发的潜在病理基础;同时认为黄曲霉毒素污染及肝病背景的普遍存在可能是启东肝癌高发的主要因素。原发性肝癌(简称肝癌)预后极差,死亡率接近于发病率。自甲胎蛋白(AFP)用于肝癌普查以来,不仅发现了较早期肝癌,而且为研究肝癌术后复发提供了一个重要的临床诊断指标。目前有相当一部分手术患者因肝癌复发而死亡。本文着重分析肝癌术后AFP转归与肝病背景关系及癌周肝病与复发的关系。为尽可能避免和减少手术不彻底及瘤栓等因素存在,因而选用瘤体在≤5厘米小肝癌作为分析对象。
This paper analyzes the relationship between AFP outcome and liver disease in 62 cases of small hepatocellular carcinoma with tumor diameter less than 5 cm. The results show that the survival rate of persistent AFP in patients after surgery, the recurrence rate of hepatocellular carcinoma and low positive and continuous positive groups There were significant differences (P<0.01). Postoperative AFP outcome was closely related to the background of liver disease, especially to the degree of cirrhosis and cirrhosis. From the low positivity after surgery to the recurrence of liver cancer symptoms, about a year or so. The median was 10.5 months; 62 cases of pericardial cirrhosis were 66.1% (41/62), of which 3/5 were moderate to severe cirrhosis; the dysplasia of hepatocytes was 77.4% (48/82). Up to 100%. It has become a potential pathological basis for the occurrence or recurrence of liver cancer; at the same time, it is believed that the prevalence of aflatoxin contamination and the prevalence of liver diseases may be the main cause of the high incidence of liver cancer in Qidong. Primary liver cancer (abbreviated as liver cancer) has a very poor prognosis, and the mortality rate is close to the incidence rate. Since AFP was used for liver cancer screening, it not only discovered the earlier liver cancer, but also provided an important clinical diagnostic index for the study of postoperative recurrence of liver cancer. At present, a considerable number of surgical patients have died of liver cancer recurrence. This article focuses on the relationship between the AFP outcome and liver disease background and the relationship between liver cancer and recurrence. In order to avoid and reduce incomplete surgery and tumor embolus and other factors as much as possible, the tumor was selected as the analysis object for small liver cancer less than or equal to 5 cm.