DIARRHEA AS A PRESENTING SYMPTOM OF HEPATOCELLULAR-CARCINOMA
DIARRHEA AS A PRESENTING SYMPTOM OF HEPATOCELLULAR-CARCINOMA
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DOI：
10.1007/bf01540166
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发表时间：
1990-06-01
影响因子：
3.1
通讯作者：
RODES, J
中科院分区：
文献类型：
--
作者：
BRUIX, J;CASTELLS, A;RODES, J
肝细胞癌（HCC）的临床表现是高度非特异性的，因为他们通常模仿肝硬化，这往往是这种肿瘤的基础。事实上，一些HCC患者出现严重腹泻，这是肝硬化中不常见的症状，促使我们确定23例连续HCC患者中腹泻的患病率，并将其与年龄，性别和肝病病因相匹配的非HCC患者组成的对照组进行比较。所有患者在入院前三个月内均接受了腹泻（定义为每天出现三次或三次以上稀便，持续三天或三天以上）的询问。两组患者在肝功能衰竭程度和存在肝损害有利因素方面相似。肝癌患者腹泻发生率明显高于非肝癌患者（47.8%比8.7%，P < 0.005）。根据Child-Pugh分级，有腹泻的HCC患者比无腹泻的患者表现出更高的碱性磷酸酶和胆红素水平以及更差的肝功能。然而，无论是肿瘤大小，血管浸润，或肿瘤分化程度这两组HCC患者之间的显着差异。这些结果表明，腹泻是肝硬化患者HCC的常见表现。因此，在这些患者出现腹泻时，应怀疑发生了HCC。
The clinical manifestations of hepatocellular carcinoma (HCC) are highly nonspecific since they usually mimic those of hepatic cirrhosis, which frequently underlies this neoplasm. The fact that some HCC patients present with severe diarrhea, an unusual symptom in liver cirrhosis, prompted us to determine the prevalence of diarrhea in a series of 23 consecutive HCC patients and compare it with that of a control group formed by cirrhotic patients without HCC, matched by age, sex, and etiology of the liver disease. All the patients were interviewed about the existence of diarrhea (defined as the presence of three or more loose stools per day appearing over three or more days) in the three months prior to admission. Both groups of patients were similar in regards to the degree of liver failure and presence of diarrhea-favoring factors. By contrast, diarhea was significantly more frequent among HCC cases than among cirrhotics without HCC (47.8% vs 8.7%, P < 0.005). HCC patients with diarrhea exhibited higher alkaline phosphatase and bilirubin levels and worse liver function, assessed by the Child-Pugh''s classification, than patients without diarrhea. However, neither tumor size, vascular invasion, or the degree of tumor differentiation were significantly different between these two groups of HCC patients. These results show that diarrhea is a frequent manifestation of HCC in patients with cirrhosis. Therefore, the development of HCC in these patients should be suspected upon the appearance of diarrhea.