Then sending _'s general knowledge of hepatocarcinoma

Then sending _'s general knowledge of hepatocarcinoma
Primary hepatocarcinoma is rare in America and Europe, it is higher than primary hepatocarcinoma and can reach 60 times to continue taking place hepatocarcinoma; The two are comparatively close in our country, but with the rising of large intestine cancer, lung cancer,etc., then sending hepatocarcinoma also has the tendency to increase. If disease this can find and adopt surgery selectively excise or person who condone surgical two steps after the treatment excise in early days, it is possible to cure; Treat while being other, may also lengthen life cycle.
In 150 medical universities of Shanghai continue taking place hepatocarcinoma corpse to examine, it accounts for 3 0 to come from digestive tract tumour. 0, come from the systematic tumour 2 9 of hematopoiesis. 3, chest tumour (lung, esophagus) 1 8 . 7, the others successively secrete urine department, woman's reproduction department, neck department, mammary gland, soft tissue,etc.. Russian K O M OB( 1 9 8 6 ) Analyze sending hepatocarcinoma of then 687, person who comes from gastrointestinal tumour 3 3. 5 (stomach 1 8. 3, large intestine 7 . 4 % ) ,Breast carcinoma 1 8 . 5, lung cancer 1 4. 7 % . U.S.A. F oster( 1 9 7 7 ) The ones that gathered 176 acquisition and excised continued it in taking place hepatocarcinoma, 126 (72) Come from large intestine cancer. Have formed, already had personned who shifts liver that can reach 7 at the time of the rectal cancer operation . 6 % - 2 4 . 4 % .All internal organs malignant tumour can be shifted to the liver through routes such as portal vein, liver artery, lymphatic vessel and soaking directly,etc., its is histologic characteristic and similar to send cancer originally,it is ashen mostly, quality is hard, come loose in occur frequently by tubercle. Amalgamate liver cirrhosis, cancer and tubercle to break, bleed etc. more rare.
Diagnose and find in early days
It continue sending hepatocarcinoma can at abdominal cavity for internal organs malignant tumour operation ago or operation at find; Can also find while following up a case by regular visits to after sending the cancer skill originally; Send cancer the intersection of skill and later stage to appear liver shift symptom or evidence and find originally mostly; A few shift cancer for first publish symptom, seek medical advice with liver, among them some can for fail, investigate, send cancer person originally till death. Continue person who send hepatocarcinoma such as tumour involve liver only, find in early days treating, can often lengthen patients, survive even up to, effect a radical cure in early days, for this reason must emphasize inferior clinical one finds this disease. Although disease this mostly can monitor, find through simple and easy A F P as primary hepatocarcinoma, notice following several o'clock, it is still easy to find inferior clinical one continues sending hepatocarcinoma: To apt to happen, continue person who send various of hepatocarcinoma take place cancer effecting a radical cure postoperative excision originally, should be fixed ' Every March - June) Put in following up a case by regular visits to and checking into the liver supersound apparently to look like the project; Effect a radical cure to the intersection of digestive tract and cancer postoperative in follow up a case by regular visits to check, acceding to and then embryo antigen of cancer (C E A) Monitoring; May take place to any malignant tumour that liver shift effect a radical cure, appear difficult by taking place symptom that cancer explains while being postoperative, especially like the low-heat of the unidentified reason, have the abdominal distension, aching, discomfort, suffer from diarrhoea, right shoulder pain,etc., should make liver supersoundApparent to look like.
There is no physical sign of obvious symptom in early days to continue taking place hepatocarcinoma, once there is clinical manifestation, focuses have been often already relatively big or more. Increase and can present the clinical manifestation the same as primary hepatocarcinoma with the cooking stove of cancer, become thin, weak, the intersection of liver and ache, abdominal distension, the intersection of belly and piece, jaundice, ascites, cachexia appear in later period, but there is not clinical manifestation of chronic hepatitis, liver cirrhosis more. Invite patient A F P <20 ng/ml of 95, a few liver from cancers such as the stomach, pancreas, ovary,etc. can measure the low density A F P to shift, the specific density is relatively high. It is not often so unusual as zymology to be early, - G T, soda phosphatase (A L P) of person who has clinical manifestation 5 ' nucleoside phosphoric acid =Esterase isoenzyme V can increase, the positive rate is invited 6 0 - 8 0 % . Every it orients minimum of diagnostic method to be about 1-2 c m at present, his positive rate can up to already 8 0 - 9 0 % .
Continue taking place hepatocarcinoma and diagnose that can consult the primary hepatocarcinoma differential diagnosis content. Have, send cancer medical history or evidence originally, have substance, district of liver, account for the intersection of location and the intersection of and pathological change but can get rid of the intersection of liver and hemangioma person; Above-mentioned zymologic masculine gender not accompanying obvious liver function to be unusual; The supersound is apparent to scan like, the nuclide liver, C T, nuclear magnetic resonance imaging (M R I) Or alternative the intersection of liver and the intersection of artery and radiography,etc. reveal scattered to account for location but can get rid of the intersection of liver and hemangioma person in the intersection of sex and substance; C E A different to explain increases etc., it is not difficult to diagnose. Inferior clinical issue continue to diagnose inferior clinical issues of the intersection of liver and cell cancer take difficult in early days hepatocarcinoma of taking place etc., but if can radically treat the postoperative patient and monitor C EA and supersound to digestive tract cancer regularly apparently to look like, it is easy to find to act as. Following several points account for location, doubt, continue person who send to the intersection of liver and substance diagnosis of hepatocarcinoma act as helpful: Often send the cancer history originally, often there are not hepatitis, liver cirrhosis or H B V that infect history and evidence; A F P is often <20 n g m l, and C E A can rise; It is here to account for the location often similar for size, occur frequently, scattered, C T or blood pool scans and has not packed, 99mT c-P M T scans negatively, the supersound shows \'s ox's eyes and solicits \.
Treat
Send cancer, can excise or excise already originally, continue the intersection of hepatocarcinoma and indication that surgery excises of sending etc.: Cancer and tubercle belongs to singly or is half limited to the liver. There are no other transformation cooking stoves in the body except liver cancer cooking stove. Tumour seat estimates that may be excised technically. The patient estimates the ability receives the excision in situation. To not suitable for the person who excises surgery ing, such as patient's situation is allowed, can carry on the condoning surgical treatment. The simple table person can use frozen surgery or high power laser gasification; Hide, occuring frequently or person who involves liver of both sides deeply, can make artery ligature of liver and/or intubate and/or liver artery thromboembolism treatment, if tumour limited to half liver should make, suffer from the intersection of side and the intersection of liver and the intersection of artery and intubate, ligature, thromboembolism, the person who involves the whole liver can consider the inherent artery intubate of liver, ligature, but should be cautious to amalgamate thromboembolism. Thromboembolism the intersection of pharmaceutical and daily lipiodol add the intersection of chemotherapy and medicine, have, add, take the intersection of gelatin and the intersection of sponge and block person also. The liver artery ligature of single side amalgamates its far section of lipiodol and gelatin sponge thromboembolism, often can reach quite obvious the intersection of tumour and necrosis, but liver artery supply organize also injuring. The person who has jaundice, ascites usually cuts open the taboo that the belly ascertains. The persons who are suitable for doing the condoning surgical treatment can also select T A E for use, has thought recently T A E is useful to many blood vessels type or few vascular cancer and tubercle. To unsuitable to cut open belly, ascertain again unsuitable to make T A E person, can be by chemotherapy, traditional Chinese medicine treatment or the radiotherapy (such as sending cancer sensitive to radiation originally) . The exertion of the chemotherapy medicine should be according to sending cancer and fixing, shift to the liver from large intestine cancer originally, it is first-selected to regard 5 - Fu and derivative as, the others can select to obey chlorine ammonium platinum according to the circumstances, M T X, A is mould and plain, mitomycin. Such as sharing with chemotherapy, traditional Chinese medicine should be supported. Continuing taking place hepatocarcinoma and can be excised, invite at the time of the cancer operation of digestive tract of about 1 20 1 0 - 3 0 % There is liver that is shifted, about 1/4 among them are or limited to but a leaf may be excised for single tubercle.
Prognosis
Continue natural course of disease that hepatocarcinoma is not treated of sending etc. ' Count or median)
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