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慢性乙型肝炎(HBV)或丙型肝炎(HCV)病毒感染是肝细胞癌的主要病因,作者前瞻性研究HBV或HCV意大利患者中肝细胞癌的初次发病率,并分析发生肝细胞癌的高危因素.对416例HBV或HCV病人监测至少5年,其中男性245例,女性171例,平均年龄548岁(38～76岁),均无临床症状.经血清HBsAg和HCV分析,69例为慢性HBV感染,340例为慢性HCV感染,7例两者兼有,病程中位值9.8年(5～14年).作经皮肝活检、体检、B超扫描、血清甲胎蛋白测定.先在6个月内复查,以后隔12～18月随访.如B超扫描显示肝占位灶或甲胎蛋白>10ng/ml,作增强CT扫描和磁共振成像,确定肝肿瘤者在B超或CT引导下做活检.初次检出肝细胞癌33例(7.9%).诊断依据异常B超扫描结果5例、甲胎蛋白升高6例、B超显示肝占位灶和甲胎蛋白升高22例.另3例初次检查均正常,后因甲胎蛋白升高作B超扫描才发现肝占位灶<3cm,共计第1年内检出36例肝细胞癌.在此36例中,35例系慢性活动性严重肝炎或伴肝硬化,这一组的肝细胞癌发生率为25%(36/140);另1例为慢性持续性肝炎,肝细胞癌的发生率为0.4%(1/276).69例HBV病人中,发生肝细胞癌4例(5.8%);在340例HCV病人中,发生肝细胞癌30例(8.8%);在7例兼有HBV和HCV病人中,发生肝细胞癌2例(28.6%).22例能行治愈性治疗(61.1%),其中11例能行肝切除术,另11?
Chronic Hepatitis B (HBV) or Hepatitis C (HCV) virus infection is a major cause of hepatocellular carcinoma. The authors prospectively studied the initial incidence of hepatocellular carcinoma in Italian patients with HBV or HCV and analyzed the high risk of developing hepatocellular carcinoma. Factors. 416 patients with HBV or HCV were monitored for at least 5 years, including 245 males and 171 females with an average age of 548 years (38-76 years). There were no clinical symptoms. Analysis of serum HBsAg and HCV showed that 69 patients were chronic. HBV infection, 340 cases of chronic HCV infection, 7 cases of both, the median disease duration of 9.8 years (5 to 14 years). Percutaneous liver biopsy, physical examination, B-scan, serum alpha fetoprotein assay. First Reexamination within 6 months, followed by follow-up every 12 to 18 months. If B-scan showed liver occupying lesions or alpha-fetoprotein >10 ng/ml, for enhanced CT scan and magnetic resonance imaging, to determine liver tumors in B- or CT Biopsy under guidance. 33 cases of hepatocellular carcinoma were detected for the first time (7.9%). Diagnosis was based on abnormal B-scan results in 5 cases, alpha-fetoprotein was elevated in 6 cases, B-mode ultrasound showed liver occupying foci and increased alpha-fetoprotein 22 Cases. The other 3 cases were all normal at the time of the initial examination. After a scan of AFP for B-scan, the liver lesion was found to be <3cm. A total of 36 cases of hepatocellular carcinoma were detected within the first year. Of the 36 cases, 35 cases were chronic active severe hepatitis or cirrhosis. The incidence of hepatocellular carcinoma in this group was 25% (36/140); the other case was chronic persistent hepatitis, and the occurrence of hepatocellular carcinoma. The rate was 0.4% (1/276). Of the 69 HBV patients, 4 (5.8%) developed hepatocellular carcinoma; in 340 HCV patients, 30 (8.8%) developed hepatocellular carcinoma; in 7 cases In HBV and HCV patients, hepatocellular carcinoma occurred in 2 cases (28.6%). 22 cases were able to receive curative therapy (61.1%), of which 11 cases were able to undergo hepatectomy and the other 11 cases.