体检对小肝癌的检出影响因素与体检方案优化分析  

Analysis of the factors affecting the detection of small hepatocellular carcinoma in physical examination and optimization of examination scheme

作　　者：张颖[1] 周仲芳[1] 罗家红[1] 熊廷莲[1] 李玲[1] 杨琴[1] 

机构地区：[1]泸州医学院附属中医院体检中心,四川泸州646000

出　　处：《泸州医学院学报》2014年第2期220-222,共3页Journal of Luzhou Medical College

摘　　要：目的:分析体检对小肝癌的检出影响因素,探讨如何优化体检方案。方法:收集2008年1月至2009年1月间年体检中检出并经病理证实的小肝癌患者甲胎蛋白(AFP)、彩超、增强CT等检查资料12例,回顾性分析其检出影响因素并总结体检优化方案。结果:12例患者均无明显的腹痛等典型肝癌临床症状。9例有慢性肝病病史,其中2例合并轻度肝硬化。AFP升高7例,彩超提示肝内结节9例,增强CT提示小肝癌12例,其中AFP升高、彩超提示肝内结节、增强CT提示小肝癌7例,彩超提示肝内结节、增强CT提示小肝癌、AFP正常5例;AFP升高、增强CT提示小肝癌、彩超未见异常3例。12例患者均行手术治疗,1年无瘤生存12例(生存率100%),5年无瘤生存10例(生存率83.3%)。结论:综合利用多种检查手段、优化体检方案能提高体检对无症状性小肝癌的检出敏感性与特异性,为临床做到早发现、早治疗、提高预后提供可靠的参考价值。Objective：To analyze the factors affecting the detection of small hepatocellular carcinoma（SHCC）in physical examination（PE）, and explore how to optimize examination scheme. Methods：Physical examination data（including AFP, color doppler ultrasound and contrast enhancement CT） of 12 SHCC detected by PE and confirmed by pathology from 2008.01 to 2009.01 were collected,the affecting factors were retrospectively analyzed,and the optimization of scheme was summarized. Results：12 patients had no obvious typical HCC symptoms such as abdominal pain. 9 cases had history of chronic liver diseases, including 2 cases complicated by mild hepatic cirrhosis. AFP raised in 7 cases, color doppler ultrasound showed intrahepatic nodules in 9 cases,and contrast enhancement CT diagnosed all 12 cases. 12 patients were performed surgical treatment, 1 year disease-free survival 12 cases（survival rate 100%）,and 5 year disease-free survival 10 cases（survival rate 83.3%）. Conclusion： Comprehensive utilization of various inspection methods and optimization of PE scheme can improve the sensitivity and specificity of detection of asymptomatic SHCC to provide clinical reliable reference value for early detection, early treatment, and improvement of the prognosis.

关 键 词：体检 小肝癌 AFP 彩超 CT 

分 类 号：R735.7[医药卫生—肿瘤] R445.3[医药卫生—临床医学]