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目的分析肝胆恶性肿瘤的家族遗传特点,确定高危人群,提高早期诊断率和手术切除率,改善预后。方法将1993年1月至2002年12月收治的胆道恶性肿瘤患者50例和原发性肝癌患者100例列为观察组,胆石症患者100例和乙型肝炎并肝硬化患者100例列为对照组。通过随访统计观察组家族成员中恶性肿瘤的发病情况。结果50例胆道恶性肿瘤患者的血缘亲属中发生恶性肿瘤1例,非血缘家属中无恶性肿瘤发生,家族中恶性肿瘤发病率为2.0%(1/50)。100例原发性肝癌患者中,血缘亲属发生恶性肿瘤22例,发生率为22.0%(22/100)。其中原发性肝癌20例,发病率为20.0%(20/100)。非血缘家属中无恶性肿瘤发生。100例胆石症和100例乙肝并肝硬化患者的血缘亲属及非血缘家属均无恶性肿瘤发生,家族发病率0。结论胆道恶性肿瘤患者家族成员之间未发现明显的家族遗传关系,单纯的家族遗传因素对胆管癌发病的影响并不大。原发性肝癌的发病有明显的家族遗传性,其一级亲属中合并乙肝(尤其合并小三阳)和肝硬化的男性成员,应列为原发性肝癌发病的极高危人群,必须严密观察,以提高早期诊断率和手术切除率,改善预后。
Objective To analyze the family hereditary features of hepatobiliary malignant tumor, identify the high-risk groups, improve the early diagnosis and surgical resection rate and improve the prognosis. Methods From January 1993 to December 2002, 50 cases of biliary malignant tumor and 100 cases of primary liver cancer were included in the observation group, 100 cases of cholelithiasis and 100 cases of hepatitis B and cirrhosis patients as control group. The incidence of malignant tumors in the family members of the observation group was observed by follow-up. Results One case of malignant tumor was found in the kinship of 50 cases of biliary malignant tumor. There was no malignant tumor in the non-blood relatives, and the incidence of malignant tumor in the family was 2.0% (1/50). Of the 100 patients with primary liver cancer, 22 were malignant tumors of kinship, the incidence rate was 22.0% (22/100). Including 20 cases of primary liver cancer, the incidence was 20.0% (20/100). Non-malignant family members no malignant tumor. 100 cases of cholelithiasis and 100 cases of hepatitis B and cirrhosis of blood relatives and non-blood relatives no malignant tumor incidence, familial incidence 0. Conclusion There is no obvious familial genetic relationship between the members of the biliary malignant tumor family members. The simple familial genetic factors have little effect on the incidence of cholangiocarcinoma. The incidence of primary liver cancer has obvious familial hereditary, its first-degree relatives with hepatitis B (especially combined with three positive) and cirrhosis of the male members should be listed as a high incidence of primary liver cancer risk group, must be closely observed, To improve the early diagnosis and surgical resection rate and improve the prognosis.