Analysis On Primary Liver Cancer Of 152 Young Patients

Objective To find out the clinical character and discuss on the clinical factor of influencing prognosis by analyzing the clinical data of the young patients with primary liver cancer.Methods The clinical data of 152 young patients with primary liver cancer(≤35ages,the group of young) in the affliliated tumor hospital of Guangxi medical University from June 2002 to May 2004 were collected .A comparison was conducted in 160 patients between the middle and old age(>35ages,the group of middle and old age) with primary liver cancer of the same period with the clinical data.The clinical factors included gender,age,family history,the way by which a tumor was found,main clinical symptoms,the level of serum alpha fetoprotein(AFP),The levels of serum ALT and AST,hepatitis B virus,the the the liver function Child-Pugh grades,liver cirrhosis,metastasis,portal vein tumor thrombi,tumor size and treatment.These clinical factors contrbuting to the survival rate of young patients with primary liver cancer were analyzed.Results1.The rate of HBsAg positive,liver cirrhosis,the level of serum AFP≥400ng/ml and portal vein tumor thrombi were respectively 96.05%,97.37%,76.32% and 57.89% in the group of young,the group of middle and old age were respectively 83.13%,90.00%,63.13% and 45.63%. the group of young was more than the group of middle and old age(P<0.05).2.The nodular,massive and diffuse liver cancer were respectively 19.74%, 51.32% and 28.95% in the group of young,the group of middle and old age were respectively 44.38%,36.88% and 18.75%. The massive and diffuse liver cancer in the group of young was moer than the group of middle and old age(P<0.05).the nodular liver cancer in the group of young was worse than the the group of middle and old age(P<0.05).3.The resection rate and the 1,3,5 years cumulative survival rate of the group of young were 13.82% and 41.45%,13.82%,7.24%. the group of middle and old age were respectively 23.13% and 57.50%,30.63%,15.63%. the group of young was lower than the group of middle and old age(P<0.05).4.The levels of serum ALT>40U/L were 79.61%(121/152) and the levels of serum AST>40U/L were 88.82%(135/152)in the group of young,the latter were higher than former(P<0.05). The levels of serum ALT>40U/L were 83.13%(133/160)and the levels of serum AST>40U/L were 88.13% (141/160) in the group of middle and old age,no singnificant difference(P>0.05). 5.The rate of HBeAg positive was 8.55% (13/152),the rate of HBeAb positive was 40.79%(62/152) in the group of young,the latter was higher than the former (P<0.05). The rate of HBeAg positive was 9.38% (15/160),the rate of HBeAb positive was 35.00% (56/160)in the group of middle and old age,the latter was higher than the former (P<0.05).6.The result of univariate analysis showed the way by which a tumor was found,liver cirrhosis,tumor size,metastasis,portal vein tumor thrombi,anti-HBc or not,the level of AFP,the liver function Child-Pugh grades and different treatment were factors which can affect the prognosis of the long time SR of the young group. The result of multivariate analysis indicated the level of AFP≥400ng/ml,portal vein tumor thrombi and tumor size were were the factors influencing the long time SR of the young people with primary liver cancer.Conclusions1.More HBsAg positive,liver cirrhosis,quick growth,strong invasiveness, more portal vein tumor thrombi,massive,diffuse liver cancer and low resection rate are the features of the young patients with primary liver cancer.2.In young patient with primary liver cancer,the increasing rate of serum AST was higher than that of ALT.3.The rate of HBeAb positive was higher than that of HBeAg in two groups.4.the level of AFP,portal vein tumor thrombi and tumor size were the independent factors effected the prognosis.