CAJ | 학술논문

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.
목적 탐토미소간암(micro hepato cellular carcinoma,MHCC)적진단여치료.방법 개전간암이급예방화건강체검,대AFP저농도양성적간장실질점위성병변진행연합진단,대간장실질성소점위진행다항영상학검사병결합간염간경화병사화AFP,발현화진치35례MHCC(직경소우2 cm).결과 35례MHCC중32례행간종류절제술(3례행완전복강경하간절제술),3례행종류사빈소융술.3례술후1년복발.35례병리균위간세포암.결론 (1)개전간암이급예방화건강체검시발현화진단MHCC적기출;(2)MHCC적진단응결합을간간경화병사、영상학검사화AFP등진행종합분석;(3)MHCC진단곤난,치료수선수술화미창소융,대중앙형MHCC술중B초정위시안전、철저절제종류적관건.
Objective To probe the approach of the diagnosis and treatment of micro hepatocellular carcinoma (MHCC).Methods Through carrying out the secondary prevention of liver cancer and medical examinadons at hospitals,liver substantial space-occupying lesion(SOL)less than 2 cm was found in 35 cases with the history of hepatitis fiver cirrhosis and the low concentration of AFP.All of them were confirmed as micro hepatocellular carcinoma (MHCC) undergone multiple imageology examinations.Results The resections of liver cancer in 32 of the 35 patients were performed; 3 cases treated with the radiofrequency ablation.Three cases recurred 1 year later.Conclusion (1)Carrying out the secondary prevention of liver cancer at hospitals and medical examinations are the foundation of early diagnosis and treatment for MHCC.(2)The diagnosis of MHCC needs comprehensive analysis with case history,imageology examination and the AFP level.(3)It is difficult for the diagnosis of MHCC.Operation and radiofrequency ablation are the first choice.Localization for central type MHCC in operation using b-sonograph is the key point for the safe and thorough removal of the tumor.