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目的：进一步评价甲胎球蛋白（ＡＦＰ）、Ｂ超（ＵＳ）、彩色多普勒血流图像（ＣＤＦＩ）、ＣＴ、ＭＲＩ、数字减影血管造影术（ＤＳＡ）和术中Ｂ超（ＩＯＵＳ）对肝癌的诊断意义。方法：对病理诊断并作ＡＦＰ，ＵＳ，ＣＴ扫描及部分其他影像检查的１６８例原发性肝癌（ＨＣＣ）的临床诊断进行分析。结果：ＡＦＰ大于正常参考水平（本院正常参考值＜３１μｇ／Ｌ）１０１例（６０．１％），＜３１μｇ／Ｌ６７例（３９．９％）。按ＡＦＰ＞４００，＞２００，及＞２０μｇ／Ｌ的标准，与病理诊断符合率分别为５１．２％，５６．０％及６０．１％。按ＵＳ与ＣＴ显示典型ＨＣＣ表现的标准，与病理诊断总符合率为８５．７％。结论：①ＵＳ与ＣＴ对ＡＦＰ阴性及低浓度阳性ＨＣＣ具有一定的独立诊断价值，在ＵＳ及ＡＦＰ检查受限时，ＣＤＦＩ及ＩＯＵＳ对小肝癌有进一步诊断意义。②ＡＦＰ增高和／或有肝占位病变，对多数病例具有诊断意义，但对不易诊断病例，特别是ＡＦＰ阴性或低浓度增高小肝癌，不易与其他非癌性肝占位病变鉴别，必须长期动态观察，直到排除或确立诊断为止。
Objective: To evaluate AFP, B ultrasound (US), color Doppler flow imaging (CDFI), CT, MRI, digital subtraction angiography (DSA) and intraoperative ultrasound (IOUS) The diagnostic significance of liver cancer. Methods: The clinical diagnosis of 168 cases of primary liver cancer (HCC) with pathological diagnosis and AFP, US, CT scan and some other imaging examinations were analyzed. Results: AFP was greater than normal reference level (normal reference value <31μg/L in our hospital) in 101 patients (60.1%) and <31μg/L in 67 patients (39.9%). According to the criteria of AFP>400,>200, and>20 μg/L, the coincidence rates with pathological diagnosis were 51.2%, 56.0% and 60.1%, respectively. According to the standard of US and CT showed typical HCC performance, the total coincidence rate with pathological diagnosis was 85.7%. Conclusion: 1 US and CT have certain independent diagnostic value for AFP negative and low concentration of positive HCC. When US and AFP examination are limited, CDFI and IOUS have further significance for small hepatocellular carcinoma. 2AFP elevation and/or hepatic lesions have diagnostic significance for most cases, but difficult to diagnose cases, especially AFP-negative or low-increased small hepatocellular carcinoma, difficult to identify with other non-cancerous liver-occupying lesions, must be long-term dynamics Observe until the diagnosis is eliminated or established.