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目的探讨微小肝癌(micro hepato cellular carcinoma,MHCC)的诊断与治疗。方法开展肝癌二级预防和健康体检,对AFP低浓度阳性的肝脏实质占位性病变进行联合诊断,对肝脏实质性小占位进行多项影像学检查并结合肝炎肝硬化病史和AFP,发现和诊治35例MHCC(直径小于2 cm)。结果 35例MHCC中32例行肝肿瘤切除术(3例行完全腹腔镜下肝切除术),3例行肿瘤射频消融术。3例术后1年复发。35例病理均为肝细胞癌。结论 (1)开展肝癌二级预防和健康体检是发现和诊断MHCC的基础;(2)MHCC的诊断应结合乙肝肝硬化病史、影像学检查和AFP等进行综合分析;(3)MHCC诊断困难,治疗首选手术和微创消融,对中央型MHCC术中B超定位是安全、彻底切除肿瘤的关键。
Objective To investigate the diagnosis and treatment of micro hepato cellular carcinoma (MHCC). Methods The secondary prevention and physical examination of liver cancer were carried out to diagnose the liver parenchymal lesion with low concentration of AFP and to perform a number of imaging studies on the small liver mass and combined with the history of liver cirrhosis and AFP. Twenty-five patients with MHCC (diameter less than 2 cm) were diagnosed and treated. Results Thirty-two of 35 MHCC cases underwent hepatic tumor resection (3 cases of complete laparoscopic hepatectomy) and 3 cases of tumor radiofrequency ablation. Three patients relapsed one year after operation. 35 cases of pathological hepatocellular carcinoma. (2) The diagnosis of MHCC should be combined with the history of hepatitis B cirrhosis, imaging examination and AFP comprehensive analysis; (3) MHCC diagnosis is difficult, Treatment of the preferred surgery and minimally invasive ablation, the central MHCC intraoperative B-positioning is safe and complete removal of the tumor key.