30岁以下青年人原发性肝细胞癌的CT特征  

CT imaging characteristics of primary hepatocellular carcinoma in patients under 30 Years of Age

作　　者：钟欢欢[1] 刘曦娇[1] 宋彬[1] 黄子星[1] 

机构地区：[1]四川大学华西医院放射科,四川成都610041

出　　处：《西部医学》2015年第4期541-544,共4页Medical Journal of West China

基　　金：国家自然科学基金面上项目(81171338)

摘　　要：目的探讨30岁以下青年人原发性肝细胞癌的CT表现特征。方法回顾性纳入<30岁经病理学确诊为原发性肝细胞癌的27例患者。分析其CT图像特征,同时收集其主诉、肿瘤标志物等临床资料。结果 27例患者中男性20例,女性7例。肿瘤中心位于肝右叶18例、肝左叶8例、肝尾叶1例。肿瘤长径>5cm 20例(74.1%)肿块内含坏死灶,小部分合并囊变、出血15例(55.5%);病灶增强扫描呈"快进快出"征象23例(85.2%);肿瘤合并门静脉癌栓7例(25.9%),患者因体检发现肝脏占位17例(63.0%)。术前血清甲胎蛋白(AFP)阳性占22例(81.5%)。中分化肝细胞癌占15例(55.6%),低、中低分化肝细胞癌占12例(44.4%)。结论 30岁以下青年人原发性肝细胞癌的增强CT表现具有一定的特征性。结合其临床病史和AFP水平有助于明确诊断。Objective To explore the CT findings of primary hepatocellular carcinoma （HCC） in patient under 30 years of age. Methods Twenty-seven patients under 30 years of age who admitted in General Surgery Department of West China Hospital and were pathology diagnosed as primary HCC from January 2013 to September 2014 were retrospectively included. The CT features as well as clinical data inlcuding chief complaint, tumor markers were analyzed. Results There are 20 males and 7 females in the 27 patients （aged 19-30 years old）. There are 17, 8, and 1 tumors with center located in the right lobe, left lobe and caudate lobe, retrospectively. The diameter of 74.1% （20/27） tumors is 5cm. 55.5 % （15/27） tumors contain necrosis, with small part of cyst and bleeding. On enhanced phase, 85.2 % lesions demonstrate ＂wash in and wash out quickly＂. 7 cancers have portal vein tumor thrombosis. 25.9% （7/27） patients found cancer while physical examination. 63% （17/27） patients complained of abdominal pain. The AFP of 81.5% （22/27） patients was positive. 55.6% of cancers （15/27） were moderately differentiated HCC while 44.4% （12/27） were poorly or mode：rately -poorly differentiated HCC. Conclusion The CT images of primary hepatocellular carcinoma （HCC） in patient under 30 years of age have certain characteristics. The clinical history and AFP are helpful for diagnosis.

关 键 词：青年人 肝细胞癌 CT 

分 类 号：R735.7[医药卫生—肿瘤]