摘要
目的:分析甲胎蛋白(alphafetoprotein,AFP)阴性肝癌的临床特点。方法:对11年间(1994-2004年)76例AFP阴性肝癌患者和2年间(2002-2003年)102例AFP阳性肝癌患者在性别、临床表现、合并疾病[乙型肝炎和(或)肝硬化]、Child-Pugh分级和γ-谷氨酰转移酶(γ-glutamyltransferase,γGT)方面进行对比分析。结果:AFP阴性肝癌患者消瘦乏力、腹痛、腹部肿块的症状少于AFP阳性肝癌患者(分别为55.3%vs82.4%、56.6%vs75.5%、13.2%vs45.1%,均P<0.05),合并乙型肝炎较AFP阳性肝癌少(68.4%vs93.1%,P<0.05),Child-Pugh分级中A级显著多于AFP阳性肝癌(56.6%vs32.4%,P<0.05),而C级显著少于AFP阳性肝癌(2.6%vs16.7%,P<0.05);AFP阴性肝癌患者中γGT异常者的比例少于AFP阳性肝癌(64.5%vs84.3%,P<0.05)。两组患者在黄疸、腹水、肝硬化和Child-Pugh分级中B级方面差异无显著性。结论:AFP阴性肝癌患者临床表现较轻且缺乏特异性,诊断时依赖于多种影像学检查和病理学检查,宜予重视。
Objective To study the clinical characteristics of primary hepatic carcinoma（PHC） with the negative alpha-fetoprotein（AFP） . Methods Seventy-six patients with AFP-negative PHC were compared with 102 cases with AFP-positive PHC in sex, clinical situation, basic diseases（hepatitis B, liver cirrhosis）, Child-Pugh grading and γ-glutamyl transferase（γGT） . Results The presences of emaciation/weakness, abdominal pain and abdominal mass in AFP-negative PHC patients were less than those in AFP-positive PHC（55. 3% vs 82.4%, 56. 6% vs 75.5%, 13.2% vs 45.5%, P 〈 0.05, 0. 05 and 0. 05, respectively）. AFP-negative PHC patients were less co-infected with hepatitis B virus than AFP-positive PHC（68.4% vs 93. 1%, P 〈 0. 05） . Child-Pugh A in AFP-negative PHC patients was more than that in AFP-positive PHC （56.6% vs 32.4% , P 〈 0. 05）, but Child-Pugh C was less than AFP-positive PHC（2. 6% vs 16. 7% , P 〈 0. 05）, AFP-negative PHC patients were less likely to have abnormal level of γGT than AFP-positive PHC（64. 5% vs 84. 3%, P 〈 0. 05 ）. Conclusion There was a lack of differentiable and special clinical characteristics in AFP-negative PHC patients, so we must pay attention to the diagnosis of AFP-negative PHC.
出处
《实用医学杂志》
CAS
2006年第5期550-551,共2页
The Journal of Practical Medicine
关键词
肝肿瘤
甲胎蛋白类
Liver neoplasms Alpha-fetoproteins
