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１９８５～１９９５年间初诊误诊肝炎肝硬变（ＨＬＣ）的原发性肝癌１８例，与配对抽取同期住院，性别、年龄相同的肝炎肝硬变１８例，将其临床表现、病毒性肝炎血清标志、生化及ＡＦＰ检测，以及Ｂ超、ＣＴ扫描影像学检查等进行对比分析，有以下鉴别注意点：１）肝脾肿大质地硬或呈结节状，持续性右上腹痛（Ｐ＜００１）。２）排除其它原因的持续低热或血性腹水（Ｐ＜００５）。３）黄疸升高与ＡＬＴ不平行，消化道症状轻（Ｐ＜００５），ＰＴＡ＜８０％。４）肝脏不大，进行性消瘦，右上腹持续隐痛，ＡＦＰ≥４００ｎｇ／ｍｌ。５）肝炎肝硬变患者ＡＫＰ、γ—ＧＴ持续增高，ＡＦＰ持续高于正常值。６）警惕ＡＦＰ阴性肝癌，早做γ—ＧＴ—Ⅱ协诊。７）警惕Ｂ超或ＣＴ扫描误诊、漏诊肝癌，强调影像学定位诊断协同ＡＦＰ、γ—ＧＴ—Ⅱ定性诊断更能减少误诊提高ＰＨＣ诊断水平。
Between 1985 and 1995, 18 cases of primary liver cancer misdiagnosed as hepatitis cirrhosis (HLC) were diagnosed. Paired with the same period of hospitalization, 18 cases of hepatitis cirrhosis with the same sex and age, and their clinical manifestations, viral hepatitis serum markers, Biochemical and AFP detection, and B-scan, CT scan imaging and other comparative analysis, the following identification points: 1) liver and spleen enlargement hard or nodular, persistent right upper quadrant pain (P <0 01) . 2) Exclude other causes of persistent fever or bloody ascites (P<005). 3) Elevated jaundice and ALT are not parallel, gastrointestinal symptoms are light (P <0 05), PTA <80%. 4) Liver is not large, progressive weight loss, persistent pain in the right upper quadrant, AFP ≥ 400 ng/ml. 5) AKP and γ-GT were persistently increased in patients with hepatitis cirrhosis, and AFP was consistently higher than normal. 6) Be alert to AFP-negative liver cancer and do early gamma-GT-II consultation. 7) Beware of B-scan or CT scan misdiagnosis and missed diagnosis of liver cancer, emphasizing that imaging diagnosis combined with AFP and γ-GT-II qualitative diagnosis can reduce misdiagnosis and increase PHC diagnosis.