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目的探讨原发性肝癌(primary liver cancer,PLC)伴肝外恶性肿瘤(extra hepatic malignant carcinoma,EHM)的临床特点。方法回顾性分析1994年1月至2003年12月江苏省高邮市人民医院及复旦大学附属中山医院经手术切除并病理证实的PLC伴EHM32例的临床资料。结果肝肿瘤直径1·5~14·5cm,≤5·0cm15例。HBsAg(+)24例,抗HCV(+)2例,AFP>20μg/L15例,伴明显肝硬化23例。入院前误诊11例。随访5年存活率为47·1%,以PLC为第二原发癌(异时性)20例,5年存活率为64·9%,PLC与EHM同时性发生12例,5年存活率为0。结论(1)PLC伴EHM具有PLC的基本特点。(2)异时性PLC伴EHM预后明显优于同时性。(3)PLC与EHM相伴使PLC易误诊为转移性肝癌。
Objective To investigate the clinical features of primary liver cancer (PLC) with extrahepatic malignant carcinoma (EHM). Methods The clinical data of 32 EHM cases with PLC and pathologically confirmed by Gaoyou People ’s Hospital of Jiangsu Province and Zhongshan Hospital Affiliated to Fudan University from January 1994 to December 2003 were retrospectively analyzed. Results The diameter of liver tumors was 1.5 ~ 14.5 cm, ≤5.0 cm in 15 cases. There were 24 cases of HBsAg (+), 2 cases of anti-HCV (+), 15 cases of AFP> 20μg / L and 23 cases of obvious cirrhosis. Misdiagnosis in 11 cases before admission. The follow-up 5-year survival rate was 47.1%, PLC as the second primary cancer (heterochronic) 20 cases, 5-year survival rate was 64.9%, PLC and EHM occurred simultaneously in 12 cases, 5-year survival rate Is 0 Conclusion (1) PLC with EHM has the basic characteristics of PLC. (2) Heterochronic PLC with EHM prognosis was significantly better than the same time. (3) PLC and EHM accompanied PLC misdiagnosed as metastatic liver cancer.