论文部分内容阅读
目的:探讨原发性肝癌(肝癌)患者门静脉癌栓(PVTT)形成的相关因素和临床特点。方法:回顾性分析肝癌106例,彩色多普勒超声检查PVTT,总结PVTT与肝癌患者年龄、肝硬化基础、肝硬化严重程度、血清乙型肝炎表面抗原(HBsAg)、丙氨酸氨基转移酶(ALT)和肿瘤指标(AFP和CEA)的相关性。门静脉高压症的诊断依据门静脉直径大于13mm,或胃镜显示食管-胃底静脉曲张。结果:106例肝癌中合并PVTT28例,其中年龄在40岁以下者占42.9%。有肝硬化基础或HBsAg阳性病例的PVTT发生率显著高于无肝硬化基础或HBsAg阴性病例,肝硬化为ChildB级和ChildC级的PVTT发生率显著高于ChildA级病例。而ALT、AFP和CEA与PVTT的发生率无明显相关性。肝癌伴有PVTT的门静脉高压症发生率显著高于无PVTT者。结论:年轻人、伴有肝硬化基础、和HBsAg阳性的肝癌,PVTT发生率高,肝硬化越重的PHC,越容易形成PVTT。PVTT形成后门静脉高压症的发生率增加。
Objective: To investigate the related factors and clinical features of portal vein tumor thrombus (PVTT) in patients with primary liver cancer (HCC). Methods: A total of 106 patients with hepatocellular carcinoma (HCC) were analyzed retrospectively. Color Doppler ultrasonography (PVTT) and PVTT were compared with age, liver cirrhosis, severity of liver cirrhosis, serum hepatitis B surface antigen (HBsAg), alanine aminotransferase ALT) and tumor markers (AFP and CEA). Portal hypertension diagnosis of portal vein diameter greater than 13mm, or endoscopy shows esophageal - gastric varices. Results: There were 28 cases of PVTT in 106 cases of HCC, of which 42.9% were under 40 years of age. The incidence of PVTT in patients with cirrhosis or HBsAg-positive was significantly higher than those without cirrhosis or HBsAg-negative cases. The incidence of PVTT in patients with cirrhosis of ChildB and ChildC was significantly higher than that of ChildA. The ALT, AFP and CEA PVTT incidence was not significantly correlated. The incidence of portal hypertension associated with PVTT in HCC was significantly higher than that in patients without PVTT. CONCLUSIONS: Young people with basal cirrhosis and HBsAg-positive hepatocellular carcinoma have a higher incidence of PVTT and more severe cirrhosis of the PHC, and PVTT is more likely to develop. The incidence of PVTT after portal hypertension is increased.