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请不用重复开贴。
我已经明确给出答案了：原发性肝癌。
有10年左右的乙肝史，HBsAg阳性患者的肝脏占位，无论AFP阴性，主要诊断都应集中在HCC，良性肿瘤的可能性很低。
至于“千分之一的几率会产生人为扩散的后果” ，不知有无数据来源？？
我提供一个数据来源：
肝活检的肿瘤针道转移率2.7％。
Gut. 2008 Nov;57(11):1592-6.
Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis.Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF.
BACKGROUND: Needle biopsy of a suspicious liver lesion could guide management in the setting of equivocal imaging and serology, although it is not recommended generally because there is the possibility of tumour dissemination outside the liver. The incidence of needle track seeding following biopsy of a suspicious liver lesion is ill-defined, however. METHODS: A systematic review and meta-analysis of observational studies published before March 2007 was performed. Studies that reported on needle tract seeding following biopsy of suspicious liver lesions were identified. Lesions suspected of being hepatocelleular cancer (HCC) were considered. Data on the type of needle biopsy, diagnosis, incidence of needle track seeding duration to seeding, follow-up and impact on outcome were tabulated. RESULTS: Eight studies identified by systematic review on biopsy of HCC were included in a meta-analysis. The pooled estimate of a patient with seeding per 100 patients with HCC was 0.027 (95% confidence interval (CI) 0.018 to 0.040). There was no difference whether a fixed or random effects model was used. Q was 4.802 with 7 degrees of freedom, p = 0.684; thus the observed heterogeneity was compatible with variation by chance alone. The pooled estimate of a patient with seeding per 100 patients per year was 0.009 (95% CI 0.006 to 0.013), p = 0.686. CONCLUSIONS: In this systematic review we have shown that the incidence of needle tract tumour seeding following biopsy of a HCC is 2.7% overall, or 0.9% per year. |
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楼主: gggmonk
发表于 2009-4-2 20:32
