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尽管肝脏外科新近取得进展,原发性肝癌预后仍很差,乃因诊断时往往合并肝硬变、肿瘤较大和多发转移,而长期生存取决于肿瘤的完全切除,因此早期发现是肝癌治疗的关键。对小肝细胞癌的最大直径没有统一限定,作者把孤立性结节最大直径小于4cm者定为小肝细胞癌。作者从1971至1983年收治小肝细胞癌行肝切除术32例,除3例外都有肝病史,HBsAg 阳性者9例,本组包括术后孤立的复发性肝癌4例。诊断方法包括血清 AFP,核素显象、超声扫描、CT 和血管造影。应用 Fisher 试验比较1971至1980和1981至1983两个时期每种诊断方法对小肝细胞癌灵敏度差异的意义。多数病人临床诊断为肝硬变,术前肝功能检查包括 ICG、A/G、胆红素和凝血酶元时间。手术指征和术式选择根据血管造影和肝影象检查的发现确定。术
Despite recent advances in liver surgery, the prognosis of primary liver cancer is still poor. It is often diagnosed with cirrhosis, large tumors, and multiple metastases. Long-term survival depends on complete resection of the tumor. Therefore, early detection is the key to liver cancer treatment. . There is no uniform limit to the maximum diameter of small hepatocellular carcinoma. The authors have designated small hepatocellular carcinoma as the largest diameter of solitary nodules less than 4cm. From 1971 to 1983, the authors treated 32 patients with small hepatocellular carcinoma undergoing hepatectomy. Except for 3 exceptions, all patients had a history of liver disease and 9 patients were positive for HBsAg. This group included 4 patients with recurrent hepatocellular carcinoma after surgery. Diagnostic methods include serum AFP, radionuclide imaging, ultrasound scans, CT, and angiography. Fisher’s test was used to compare the significance of the difference in the sensitivity of each diagnostic method for small hepatocellular carcinoma between 1971-1980 and 1981-1983. Most patients had a clinical diagnosis of cirrhosis, and preoperative liver function tests included ICG, A/G, bilirubin, and prothrombin time. The surgical indications and surgical options were determined based on findings from angiography and liver image examinations. Surgery