超声体检在早期发现无症状肝癌和小肝癌的临床诊断价值  

Ultrasound examination in early detection of asymptomatic liver cancer and small hepatocellular carcinoma

作　　者：陈淑贞[1] 唐妍[1] 程志坚[1] 周芳[1] 戚小艺[1] 

机构地区：[1]南方医科大学附属小榄医院超声科,528415

出　　处：《中华普外科手术学杂志（电子版）》2016年第2期171-173,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的分析超声体检对早期发现无症状肝癌和小肝癌的临床诊断价值及预后判断。方法将病理确诊的32例肝癌患者按入院体检时有无症状,分无症状肝癌组和症状性肝癌组进行回顾性分析。应用SPSS17.0软件进行数据分析,计量资料如患者年龄以均数±标准差（x珋±s）表示,两两比较采用t检验,计数资料如患者性别、肝癌种类、随访率、符合率、误诊率等用百分率表示,两两比较采用χ^2检验,P0.05）;但超声检查符合率明显高于CT平扫诊断肝癌的56.25%,比较差异有统计学意义（χ^2=10.925,P〈0.05）。患者术后随访3年,无症状肝癌组术后1、2、3年无瘤生存率分别为95.23%（20/21）、90.48%（19/21）、66.67%（14/21）;症状性肝癌组为90.91%（10/11）、54.55%（6/11）、27.27%（3/11）;术后2、3年无瘤生存率无症状肝癌组明显高于症状性肝癌组（χ^2=4.848,4.499,P〈0.05）。结论超声检查是筛查早期无症状性肝癌和小肝癌的有效方法,值得临床推广。Objective To analyze the clinical diagnostic and prognostic value of ultrasound examination in early detection of asymptomatic liver cancer or small hepatocellular carcinoma.Methods Thirty-two patients with liver cancer were divided pathologically into an asymptomatic group and a symptomatic group. Clinical data of the 32 patients were retrospectively analyzed using SPSS17. 0 software.Measurement data such as patient age represented as mean ± standard deviation were examined by Student＇s t test. Count data such as gender,type of liver cancer,follow-up rate,and misdiagnosis rate were expressed as percentages and examined using the Chi-square test（ P 〈 0. 05）. Results Ultrasound examination revealed solid liver lesions in 35 patients with a coincidence rate of 91. 43%,and misdiagnosis in 3 patients. The coincidence rate of contrast-enhanced CT scan was 93. 75% for solid liver lesions as liver cancer,and misdiagnosis in 2 patients（ P 〈 0. 05）. The coincidence rate of ultrasonography was higher than56. 25% for CT scan in liver cancer diagnosis（ χ~2= 10. 925,P 〈 0. 05）. The patients were followed up for 3 years. The 1-,2-,3-year disease-free survival rates in the asymptomatic group were 95. 23%（ 20 /21）,90. 48%（ 19 /21）,and 66. 67%（ 14 /21） respectively,whereas those in the symptomatic group were90. 91%（ 10 /11）,54. 55%（ 6 /11）,and 27. 27%（ 3 /11） respectively. The disease-free survival rates after 2 and 3 years in the asymptomatic group were higher than those in the symptomatic group（ χ~2= 4. 848,4. 499 respectively; P 〈 0. 05）. Conclusion Ultrasonography is an effective method for early screening of asymptomatic liver carcinoma or small hepatocellular carcinoma.

关 键 词：肝肿瘤 早期诊断 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]