原发性肝癌伴癌综合征的发生率及其临床特点  

The incidence and clinical significance of paraneoplastic syndromes in patients with primary hepatic carcinoma

作　　者：章静[1] 黄柳清 曾方银[1] 

机构地区：[1]安徽省淮南市妇幼保健院检验科,232007 [2]广东省广州市污水治理有限责任公司,510100

出　　处：《国际检验医学杂志》2011年第9期927-928,931,共3页International Journal of Laboratory Medicine

基　　金：广东省自然科学基金资助项目(9451051501003704)

摘　　要：目的探讨原发性肝癌(PHC)患者伴癌综合征(PNS)的发病率、临床特征及其实验室指标的变化规律。方法回顾性分析166例PHC患者临床生化、血常规、甲胎蛋白(AFP)、HBsAg、HCV-Ab等实验室检查结果,比较PNS组与非PNS组的差异。结果 25.9%(43/166)的PHC患者出现PNS表现,其中19例有1种PNS表现,16例有2种PNS表现,5例出现3种PNS表现。PNS患者高胆固醇血症占同期PHC住院患者的15.1%,白细胞增多症占9.0%,血小板增多症占7.8%,红细胞增多症占4.2%,低糖血症占6.6%,高钙血症占1.8%。PHC患者PNS组平均AFP水平、乙肝病毒与丙肝病毒感染血清标志物阳性率、血清总胆固醇、血钙、白细胞、血小板、碱性磷酸酶的实验室检查结果同非PNS组相比差异均有统计学意义(P<0.05)。结论 PHC患者PNS的发生率较高,多项实验室指标有其独特特点且对减少PHC的误诊率、调整治疗方案、疗效评价和预后判断均具有重要意义。Objective To investigate the incidence,clinical significance and the diversity rule of laboratory items of paraneoplas tic syndromes（PNS） in patients with primary hepatic carcinoma（PHC）. Methods The detection results of clinical biochemistry, blood routine test, alpha fetoprotein（AFP）, HBsAg and HCV-Ah of 166 patients with PHC were reviewed retrospectively. Data from PNS group and nomPNS group were analyzed. Results 25.9% （43/166） of patients with PHC were with complicated with PNS,among whom 19 patients with one kind of PNS clinical situation, 16 with two kinds and 5 with three kinds. Hypercholesterolemia was found in 15.1 %, leucocytosis in 9.0 %, thrombocytosis in 7.8 %, erythrocytosis in 4.2 %, hypoglycemia in 6.6 % and hypercalcemia in 1.8 % of the hospitalized patients with PHC. There were statistical differences of AFP, positive rates of HBsAg and HCV-Ab, total cholesterol, blood calcium,white blood cells, platelets and alkaline phosphatase between PNS and non PNS groups. Conclusion The incidence of PNS in patients with PHC is relatively high, with unique characteristics in many laboratory items, which might have important value to the reduction of misdiagnosis rate, the adjustment of treatment scheme, the evaluation of treatment effect and the judgment of prognosis.

关 键 词：肝肿瘤 生物医学研究 伴癌综合征 

分 类 号：R735.7[医药卫生—肿瘤]