| Objective: To understand the basic clinical features and diagnosis and treatment status for inpatients with primary hepatocellular carcinoma(HCC)in the First Affiliated Hospital of Hainan Medical College,and to provide a theoretical basis for the standardized diagnosis and treatment of HCC in our hospital,by the concluding and summarizing the epidemiological characteristics,clinical manifestations,causes,liver function indexes,AFP,Child-pugh classification,staging,therapeutic method,and antiviral therapy for the patients.Methods: Through the medical record system of the First Affiliated Hospital of Hainan Medical College,inpatients(a total of 554 cases)first diagnosed with HCC from January 1,2012 to December 31,2015 were collected,the general datas of patients(gender,age,family history,smoking history,drinking history),main symptoms,carrying situation of HBV and / or HCV,liver function index(ALT、AST、ALP、GGT、CHE、ALB、TBIL、DBIL、IBIL、PAB),coagulation function,alpha-fetoprotein(AFP),PS score,Child-pugh classification,staging,therapeutic method,antiviral therapy and other data were counted.The survival time of patients were followed up,according to treatment plan recommended by diagnosis and treatment standard of the primary liver cancer(2017 edition),the proportion of standardized treatment and the proportion of anti-viral treatment in our hospital were retrospectively studied,and differences of the survival period with standardizedtreatment and non-standardized treatment and each laboratory examination index in different stages were compared for HCC patients in the same stage.Statistical software SPSS 20.0 was performed for statistical analysis.Results: 1.Among 554 cases of newly diagnosed HCC inpatients,484 cases(87.4 %)were male and 70 cases were female(12.6 %),the ratio of male to female is6.91:1.The average age was(55.42±12.259)years old,the age of male was(54.90±11.885)years old,the age of female was(59.00±14.170)years old,the age of onset for male and female was statistically significant(t =-2.628,p =0.009).2.Among554 cases of newly diagnosed HCC inpatients,abdominal pain and abdominal distension were the most common clinical manifestations.There were two or more clinical manifestations in general,among 294 patients experienced abdominal pain(53.1%),132 patients experienced abdominal distension(23.8%),80 patients had no obvious clinical manifestations and the disease were found by physical examination(14.4 %).3.Among 554 cases of newly diagnosed HCC inpatients,99.1% finished liver CT examination or/and MRI,AFP examination,28.9% did not finish HBV-DNA examination,and 30% of them AFP≤30μg/L.4.Among 554 cases of newly diagnosed HCC inpatients,HBV infection was still the main one(88.8%),two cases were combined with HCV infection,and only 196 cases received anti-HBV therapy(39.7 %).5.Among 554 cases of newly diagnosed HCC inpatients,48.9% had the medical history of liver cirrhosis.6.Among 554 cases of newly diagnosed HCC inpatients,the highest proportion(95.1 %)of PS score was 0 ~ 2,the highest proportion(89.7%)of Child-pugh was A and B.7.Among 554 cases of newly diagnosed HCC inpatients,the late stage was main one,89 cases of which(16.1 %)were in IIIa stage,174 cases(31.4 %)were in IIIb stage,and 60 cases(10.8 %)were in IV stage.8.Among 554 cases of newly diagnosed HCC inpatients,there was a significant difference between PT,AT-Ⅲ,ALT,AST,ALP,GGT,CHE,TP,ALB,GLB,TBIL,DBIL,IBIL,PAB,AFP in various stages(p < 0.05).9.Among 554 cases of newly diagnosed HCC inpatients,272 cases was treated with standardized treatment(49.1 %),and 282 cases was treated with non-standardized treatment(50.9 %),the median survival time of the standardized treatment group was 24 months,the median survival time of the non-standardized treatment group was 4months,and the overall survival time was 14 months.The function curves of the two groups was statistically significant by Log Rank test(p = 0.000).Conclusions: 1.HCC patients in our hospital are mostly male,so clinical manifestations are lack of specificity,which is closely related to HBV infection and cirrhosis.2.The proportion of HCC standardized diagnosis and treatment in our hospital is relatively low,which is mainly manifested in the low stage awareness,low anti-viral treatment ratio,easy to ignore the replication of HBV,the low proportion of surgical resection in patients with surgical resection,the increased trend of TACE treatment,and the low proportion of patients in advanced patients with sorafenny targeted therapy.The reasons may be related to the patients and their families’ treatment intentions,economic conditions,with other basic diseases,hope to be in a superior hospital,low medical insurance reimbursement ratio,difficulty in targeted drug purchases and not covered by insurance,and the first consultation department or the receiving doctor’s cognition of HCC treatment methods.3.For diagnosis and treatment of HCC,multiple departments are required to jointly develop individualized treatment programs to get maximum control of tumour. |
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