摘要
目的对比分析原发性肝癌(PLC)中HBV相关肝癌(HBV-PLC)与非病毒相关肝癌(NBNC-PLC)两者临床特征,并探讨差异部分背后的原因,为PLC的临床诊治以及相关研究提供参考。方法选取2018年3月至2021年3月在贵州中医药大学第二附属医院肿瘤内科住院的47例PLC患者,其中HBV-PLC组28例、NBNC-PLC组19例,对比分析两组临床资料。结果两组在性别上没有统计学差异(P>0.05);HBV-PLC组患者[(60.97±12.18)岁]的发病年龄比NBNC-PLC组患者[(69.28±11.73)岁]年轻约10岁(P<0.05);影像学上两组在肿瘤个数、门静脉癌栓形成、肿瘤大体病理分型以及淋巴转移方面无统计学差异(P>0.05),但在肿瘤病灶位置上,HBV-PLC好发于肝右叶,而NBNC-PLC倾向于肝左叶(P<0.05),且HBV-PLC比NBNC-PLC更容易发生远处转移(P<0.05);组织病理分型上HBV-PLC倾向于肝细胞癌(HCC),而NBNC-PLC倾向于胆管细胞癌(CC)(P<0.05),但在分化程度上两组无统计学差异(P>0.05);在TNM、BCLC分期上两组没有统计学差别(P>0.05);血生化指标方面,两组在TP、Alb、GLO、ALP、CHE、LDH上无显著差异(P>0.05),但在AST、ALT、TBil、DBil、IBil、TBA、γ-GT以及Child-Pugh分级上有统计学差异(P<0.05),HBV-PLC肝功能相对较差;肿瘤标志物上两组的CEA、CA125、CA199、CA724没有统计学差异(P>0.05),而HBV-PLC血清AFP明显高于NBNC-PLC(P<0.05);凝血功能方面,HBV-PLC患者PT、INR、TT要更长,而PTA、FIB则相对较低(P<0.05),APTT上两者无统计学差异(P>0.05)。结论HBV-PLC多为HCC,有发病较年轻、病灶好发于肝右叶、易发生远处转移、血清AFP高,且肝功能、凝血功能差的特点;而NBNC-PLC多为CC,发病年纪更大,病灶好发于肝左叶,不易发生远处转移、血清AFP低,肝功能及凝血功能较好。
Objective To compare and analyze the clinical characteristics between patients with hepatitis B virus-related primary liver cancer(HBV-PLC)and non-virus related primary liver cancer(NBNC-PLC),and explore the mechanism of the differences,in order to provide a reference for the clinical diagnosis and treatment of PLC.Methods 47 cases of PLC patients hospitalized in the Department of Oncology,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from March 2018 to March 2021 were enrolled in this study,including 28 cases in the HBV-PLC group and 19 cases in the NBNC-PLC group.Patients in the NBNC-PLC group were both negative in hepatitis B viral surface antigen and hepatitis C viral antibody.The clinical data of these two groups of PLC patients were compared and analyzed.Results There was no significant difference in genders between the two groups(P>0.05).The onset age of HBV-PLC patients(60.97±12.18)was about 10 years younger than that of NBCC-PLC patients(69.28±11.73)(P<0.05).There were no significant differences in the numbers of tumors,formation of portal vein tumor embolus,tumor pathological classifications and lymphatic metastasis between the two groups(P>0.05).However,HBV-PLC was more likely to locate in the right lobe of liver,whereas NBNC-PLC was more likely to occur in the left lobe of liver(P<0.05).HBV-PLC was more likely to have distant metastasis than NBNC-PLC(P<0.05).HBV-PLC tended to have more hepatocellular carcinoma(HCC),while NBNC-PLC tended to have more cholangiocellular carcinoma(CC)(P<0.05).There was no significant difference between the differentiation degrees of the two groups(P>0.05).There was no significant difference in the TNM and BCLC stages between the two groups(P>0.05).In terms of liver function,total protein(TP),albumin(Alb),globumin(GLO),alkaline phosphatase(ALP),cholinesterase(CHE)and lactate dehydrogenase(LDH)levels were not significantly different between the two groups(P>0.05),but aspartate aminotransferase(AST),alanine aminotransferase(ALT),total
作者
李建
成警花
田杰
李囿萱
廖德仲
徐静
LI Jian;CHENG Jing-hua;TIAN Jie;LI You-xuan;LIAO De-zhong;XU Jing(Graduate School of Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;Department of Oncology,The Second Affiliated Hospital of Guizhou University of Chinese Medicine,Guiyang 550003,China;Guizhou Medical University,Guiyang 550004,China)
出处
《肝脏》
2022年第4期460-465,共6页
Chinese Hepatology
基金
国家自然科学基金(81660501、82060489)。
关键词
HBV相关肝癌
非病毒相关肝癌
临床特征
hepatitis B virus-related primary liver cancer
non-virus-related primary liver cancer
hepatitis B virus surface antigen
hepatitis C virus antibody
clinical features
