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老年人原发性肝癌的早期诊断应做到以下几点:1 定期体格检查。老年人慢性肝病者仍为肝癌高危人群,应定期随诊。2 早期诊断主要依靠影像学(B 型超声)及血清学检查。AFP 是诊断肝癌最特异的标志物,但近年AFP 阴性肝癌有上升趋势,因此,血清标志物联合检测,可明显提高肝癌的阳性检出率;磁共振成像对肝癌捡出率高。3 肝癌高度可疑者,还可采用超声引导下经皮肝穿刺活检或穿刺抽吸细胞学检查。
The early diagnosis of primary liver cancer in the elderly should do the following: 1 regular physical examination. Elderly people with chronic liver disease are still at high risk of liver cancer and should be followed up regularly. 2 Early diagnosis relies mainly on imaging (B-mode ultrasound) and serological tests. AFP is the most specific marker for the diagnosis of liver cancer, but in recent years, AFP-negative liver cancer has been on the rise. Therefore, combined detection of serum markers can significantly increase the positive detection rate of liver cancer; magnetic resonance imaging has a high rate of liver cancer rejection. 3 Suspected cases of hepatocellular carcinoma can also be guided by ultrasound-guided percutaneous biopsy or puncture aspiration cytology.