血清AFP、GGT结合CT和肝动脉造影对原发性肝癌诊断的意义  

Study on the combined detection of AFP,GGT and spiral CT hepatic arteriography for diagnosis of primary hepatic cancer

作　　者：陈志伟[1] 叶晓光[1] 何明基[1] 罗润齐[1] 黄远明[1] 于宪[1] 

机构地区：[1]广州医学院第二附属医院,广东广州510260

出　　处：《中国热带医学》2006年第10期1778-1779,共2页China Tropical Medicine

摘　　要：目的探讨血清甲胎蛋白(AFP)、γ-谷氨酰转移酶(GGT)结合CT和肝动脉造影影像学检查对原发性肝癌(PHC)诊断的临床意义。方法对197例PHC患者血清AFP、GGT水平结合CT和肝动脉造影检查结果进行分析。结果197例肝动脉造影检查均为PHC.其中21例AFP和GGT正常的病人,CT检查为PHC17例(80.9%),34例AFP正常GGT升高的病人,CT检查为PHC31例(91.2%),142例AFP和GGT同时升高的病人,CT检查为PHC131例(92.3%);CT检查为巨块型肝癌的163例中,经肝动脉造影检查为弥漫型有7例;CT检查为结节型肝癌的20例中,经肝动脉造影检查为弥漫型有2例;163例CT检查为单一巨块型肝癌,经肝动脉造影检查发现存在癌肿周边子灶有41例。197例患者中,38例肝动脉造影检查发现存在动-静脉瘘。结论对血清AFP和GGT的联合检测结合CT及肝动脉造影检查可明显提高PHC诊断率;肝动脉造影检查更能明确PHC的临床分型、肿瘤血供情况和是否存在早期肝内转移病灶,对选择治疗方案具有重要的临床参考价值。Objective To explore the clinical value of alpha- fetoprotein（ AFP）, gamma - glutamyltransferase （GGT） combined with spiral CT and hepatic arteriography in diagnosis of primary hepatic cancer （PHC）. Methods Serum AFP and GGT in 197 cases with PHC were determined and analyzed in combination with the results of CT and hepatic arteriography. Results 197 PHC cases were diagnosed by hepatic arteriography. 17 out of 21 cases with normal serum AFP and GGT were diagnosed as PHC cases by CT （80.9%）. 31 out of 34 cases with normal serum AFP and high GGT were diagnosed as PHC cases by CT （92.3%）.. 131 out of 142 cases with high level of serum AFP and GGT were diagnosed as PHC cases by CT. 7 out of 163 cases with large mass cancer by CT were diagnosed as diffuse type of PHC cases by hepatic arteriography. 2 out of 20 cases with node cancer by by CT were diagnosed as diffuse type PHC cases by hepatic arteriography. 41 out of 163 cases with only large mass cancer by CT were diagnosed as satellite nodule of hepatocellular carcinoma cases by hepatic arteriography. 38 out of 197 cases with traumatic artefiovenous fistula by hepatic artefiography were diagnosed as hepatic artefiography. Conclusion The joint determination of serum AFP, GGT in combination with CT and hepatic arteriography are valuable for diagnosis of PHC. Hepatic arteriography can detect histopathologic type of PHC, evaluate blood supply of PHC and the intrahepatic metastasis. It possesses the clinical reference value in selection of treatment schemes.

关 键 词：原发性肝癌 甲胎蛋白 Γ-谷氨酰转移酶 CT肝动脉造影 

分 类 号：R735.7[医药卫生—肿瘤]