García Compeán D, Guzmán de la Garza F J, Muñoz Espinoza L E, Valadez Castillo R, Martínez Flores A M, Fernández B A, Escobedo M, Barragán R F
Departamento de Medicina Interna, Facultad de Medicina, Hospital Universitario Dr. José E. González, U.A.N.L., Monterrey.
Rev Gastroenterol Mex. 1994 Jan-Mar;59(1):17-22.
Epidemiological, clinical, biochemical and topographic features of primary hepatic cancer (PHC) were reviewed retrospective and prospectively in this study. This review consisted of 76 patients from 1971 to 1990. Forty nine males and 27 females. The mean age was 66.1 +/- 11.7 years. Hepatocellular carcinoma (HC) was the most frequent histological type (84.1%), followed by cholangiocarcinoma (87.7%). Mixed carcinoma and hepatoblastoma were 4.3 and 2.9% respectively. The prevalence af PHC among 1485 autopsies was 0.74%. The most frequent sites af metastasis were the lungs (66%) and portal vein (50%). Hepatocellular carcinoma was associated to cirrhosis in 80% of the cases. A syndrome including asthenia, weight loss, hepatomegaly and cholestasis was identified in most of the patients, and alkaline phosphatase was the most frequently disturbed laboratory test. 60% of tumors were bilateral and none of the solitary tumors had less than 5 cms in diameter. 20% of HC showed normal serum levels of AFP (< 20 ng/ml). 40% had at least one of the markers of B virus hepatitis in serum.
本研究回顾性和前瞻性地分析了原发性肝癌(PHC)的流行病学、临床、生化和形态学特征。该回顾性研究纳入了1971年至1990年期间的76例患者,其中男性49例,女性27例,平均年龄为66.1±11.7岁。肝细胞癌(HC)是最常见的组织学类型(84.1%),其次是胆管癌(87.7%)。混合性癌和肝母细胞瘤分别占4.3%和2.9%。在1485例尸检中,PHC的患病率为0.74%。最常见的转移部位是肺(66%)和门静脉(50%)。80%的肝细胞癌病例与肝硬化有关。大多数患者出现了包括乏力、体重减轻、肝肿大和胆汁淤积在内的综合征,碱性磷酸酶是最常出现异常的实验室检查指标。60%的肿瘤为双侧性,所有直径小于5厘米的肿瘤均为单发。20%的肝细胞癌患者血清甲胎蛋白水平正常(<20 ng/ml)。40%的患者血清中至少有一种乙型肝炎病毒标志物阳性。