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我国首发肝癌登记新数据,肝癌主要致病诱因是病毒性肝炎,没马兜铃酸什么事

2017-11-10 凤凤 医师报

近日,中国临床肿瘤学会年会上,由秦叔逵教授牵头的《中国原发性肝癌临床登记调查 (CLCS)》初步结果公布。结果显示,肝细胞癌(HCC)为我国原发性肝癌(PLC)最常见病理类型,男性患者居多,毒性感染和(或)饮酒是致病主因,AFP、肿瘤分期和病理学分级是HCC诊断和预后的重要指标。


近日,中国临床肿瘤学会年会上,由秦叔逵教授牵头的《中国原发性肝癌临床登记调查 (CLCS)》初步结果公布。结果显示,肝细胞癌(HCC)为我国原发性肝癌(PLC)最常见病理类型,男性患者居多,毒性感染和(或)饮酒是致病主因,AFP、肿瘤分期和病理学分级是HCC诊断和预后的重要指标。

此次公布的结果显示,原发性肝癌共5114例,其中2940例(57.49%)有病理诊断。最常见的病理类型为HCC占87.99% (2587/2940),其次为肝胆管细胞癌(4.80%),混合型肝癌(2.96%),病理类型不确定的为4.25%(图1)。

首诊年龄为10.6~92.1岁(中位年龄54.6岁),男性占大多数,为4229例(82.69%),是女性的4.7倍。

患者多数既往有基础肝病、糖尿病和(或)高血压(90.83%);仅有乙肝者2599例(50.82%),仅有丙肝者145例(2.83%),乙肝合并丙肝者13例(0.25%);病毒性肝硬化1590例(31.09%);不确定肝硬化类型者135例(2.63%);其他肝病(酒精性肝病、脂肪肝) 5例(0.09%,图2)。

关于个人嗜好的调查结果显示,长期吸烟者为38.50%、长期饮酒者为35.78%、乙肝炎感染同时饮酒者为35.43%。

59.22%的患者首诊时血清甲胎蛋白(AFP)阳性(≥20 ng/ml),其中32.58%患者AFP≥400 ng/ml;22.27%患者存在肝功能异常(图3)。

纳入患者的肝功能Child-Pugh分级以A级为主(62.19%),B级和C级分别占36.16%和1.65%。BCLC分期最多的为C期(47.95%),A期和B期各占23.81%和25.55%、D期占1.85%、0期最少,为0.83%(图4)。

记录临床分期的有4222例,最多为Ⅰ期2447例(57.96%),其次为Ⅱ期1051例(24.89%)、Ⅲ期713例(16.89%)、Ⅳ期11例(0.26%)。

不同病毒性肝炎背景HCC患者之间,发病特点存在差异,乙肝相关性HCC 最多,中位首诊年龄53.60岁(18.6~92.1岁)。

结果显示,与肿瘤分期相关的主要因素为血清AFP水平。AFP是否正常(<20 ng/ml)与乙肝病史、病灶个数、肿瘤最大直径、血管侵犯、远处转移以及腹水之间均存在相关性。

5100例可进行治疗方式分析的患者中,2624例(51.31%)采取手术治疗,其中肝移植仅占0.01%,其他治疗方式依次为TACE(31.24 %)、消融治疗(14.18 %)、全身化疗(1.35%)、单用中医药治疗(1.19%)、分子靶向药物治疗(0.61%)、放疗(0.18%)和放射性粒子植入治疗(0.14%)。

秦教授总结,调研的18家医院2012-2016年收治的PLC患者,HCC为最常见病理类型,病毒感染和(或)饮酒是主要致病因素。我国患者首诊时病期普遍较晚,积极手术和综合治疗是改善预后的重要方法。

经多年努力,我国HCC预后正在改善。下一步要扩大区域、收集不同医院、学科和专业的肝癌病例,规范临床收治行为和数据采集。 

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    2018-01-13 howi
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  3. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-28 wl1122050

    消融技术包括立体定向放疗?

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Wed Nov 15 19:08:57 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260464, encodeId=d8672604648d, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sat Nov 11 08:43:31 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260445, encodeId=e7602604452c, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/01/a422505c84c5bd7df245dee314debefc.jpg, createdBy=31332101574, createdName=kalery, createdTime=Sat Nov 11 08:10:36 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260438, encodeId=ab1f26043869, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:16 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260437, encodeId=06b726043e00, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-15 神功盖世

    学习

    0

  5. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 大爰

    学习了谢谢分享!!

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 kalery

    好文章学习了

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 榄枷檬

    谢谢分享

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/01/a422505c84c5bd7df245dee314debefc.jpg, createdBy=31332101574, createdName=kalery, createdTime=Sat Nov 11 08:10:36 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260438, encodeId=ab1f26043869, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:16 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260437, encodeId=06b726043e00, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 榄枷檬

    学习学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1986362, encodeId=d68d198636219, content=<a href='/topic/show?id=f3f1e0930ed' target=_blank style='color:#2F92EE;'>#病毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70930, encryptionId=f3f1e0930ed, topicName=病毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sat Jan 13 21:55:00 CST 2018, time=2018-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810893, encodeId=c0d918108935d, content=<a href='/topic/show?id=f0f886490e5' target=_blank style='color:#2F92EE;'>#致病诱因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86490, encryptionId=f0f886490e5, topicName=致病诱因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c82369, 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Wed Nov 15 19:08:57 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260464, encodeId=d8672604648d, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sat Nov 11 08:43:31 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260445, encodeId=e7602604452c, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/01/a422505c84c5bd7df245dee314debefc.jpg, createdBy=31332101574, createdName=kalery, createdTime=Sat Nov 11 08:10:36 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260438, encodeId=ab1f26043869, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:16 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260437, encodeId=06b726043e00, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 smartxiuxiu

    科普!科普去

    0

  10. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/01/a422505c84c5bd7df245dee314debefc.jpg, createdBy=31332101574, createdName=kalery, createdTime=Sat Nov 11 08:10:36 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260438, encodeId=ab1f26043869, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:16 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260437, encodeId=06b726043e00, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Sat Nov 11 08:02:13 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260433, encodeId=286b26043344, content=科普!科普去, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:42:02 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=260431, encodeId=adbc260431d6, content=广而告之!科普太重要了., beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Sat Nov 11 07:40:43 CST 2017, time=2017-11-11, status=1, ipAttribution=)]
    2017-11-11 smartxiuxiu

    广而告之!科普太重要了.

    0

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