Clinical Analyses Of Primary Liver Cancer Associated With Pregnancy And Review Of The Literature

OBJECTIVE Primary carcinoma of the liver in pregnancy is a rare disease. It is generally believed to have a better prognosis than those non pregnant patients with primary liver cancer. In this article, we collected domestic and internatio-nal data from literatures to analyze and summarize the etiology, clinical characteristics, diagnosis, treatment and prognosis of this disease, in order to improve the understanding of the disease, to provide potential guidance for the diagnosis and treatment for primary liver cancer complicated with pregnancy.METHODS The clinical data of 9 cases of liver cancer associated with pregnancy were collected from 2005 January to 2015 January in the First Affiliated Hospital of Guangxi Medical University, as well as from literature focusing on hepatocellular carcinoma complicated with pregnancy, in terms of the clinical features, diagnostic methods,treatment methods, for the epidemiol-ogical analyses.RESULTS 9 cases of liver cancer associated with pregnancy were at an average age of 29.78±7.87 years. The diagnosis of gestational weeks was 25.57 ±8.62 weeks on average. Patients with upper abdominal pain and discomfort were found in 5 cases; 8 were had associated with the history of hepatitis B; hepatitis B surface antigen (HBsAg) was tested positive in 6 cases; diagnoses were confirmed in 6 cases with abdominal B ultrasound, CT and AFP levels,3 cases were confirmed through pathology; alpha fetoprotein (AFP) level of all patients varied at the range of 106.6-60500 ng/ml; the follow-up was achieved through imaging examination of 6cases, the maximum diameter of the tumor averaged 12.73±3.93cm (range 6.6-19cm), the size of tumor maximum diameter 5-10cm in 2 cases, with the largest diameter>10cm in 6 cases.The main treatment method for 5 cases was artificial abortion; 2 cases delayed treatment, fetal maturity after cesarean section; 5 patients gave up treatment; 1 case was treated with TACE at a time; 1 case was treated with Huaier granule; two cases of patients diagnosed with postpartum were five weeks after birth, six weeks underwent surgery. After treatment,6 patients died during the follow-up period,1 cases lost follow-up, two cases of surgical resection were tumor-free survival of patients already 5 years,6 years. Only 4 fetus survived.CONCLUSION primary liver cancer associated with pregnancy lacks specific clinical manifestations, at the time of diagnosis are of advanced hepatocellular carcinoma, poor prognosis; primary hepatocellular carcinoma complicated with pregnancy in HBsAg positive pregnant womenduring pregnancy, strengthen the monitoring of HBsAg positive patients, can improve the early diagnosis of abdominal B ultrasound; serum AFP, as the main method of prenatal screening for liver cancer for suspected liver cancer during pregnancy, MRI should be performed to assess the tumor nature and stage of pregnancy; once the diagnosis of primary liver cancer in pregnancy should be terminated immediately, accordi-ng to liver cancer clinical staging standardized treatment for liver cancer, resection operation, operation treatment should should be as early as possbie; primary hepatocellular carcinoma with liver cancer staging and clinical prognosis of pregnancy closely related, early detection, early diagnosis, early treatment can improve the prognosis.