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肝细胞癌(HCC)的生物学特性和甲胎蛋白(AFP)检查的敏感度有地区差异,本文报道意大利地区用 AFP 和超声波(US)筛选 HCC 的前瞻性研究。选用157例(男90,女67)活检证实的无症状肝硬化病人,平均年龄68岁,其中20例乙型肝炎病毒表面抗原(HBsAg)阳性,94例抗-HBsAg 和/或抗病毒核抗体(抗-HBc)阳性。全部病人入院当时及其后每隔半年追踪检查 US 和 AFP1次,共达2年。凡 US 发现有病变者,均作穿刺或剖腹活检。确诊为 HCC 者,每3个月追踪检查 US,并测定 AFP。入院 US 筛选检查结果发现,13例有灶性病灶,经活检证实 HCC 者10例。2年的 US 追踪检查才发现HCC 者5例。上述15例(男13,女2)均属早期癌,瘤体<5cm。其中 HBsAg 阳性2例。作者发现,如果以 AFP>400ng/ml 作为 HCC 诊断标准,
There are regional differences between the biological characteristics of hepatocellular carcinoma (HCC) and the sensitivity of AFP examination. This article reports a prospective study of screening HCC with AFP and ultrasound (US) in Italy. A total of 157 patients (male 90, female 67) biopsy confirmed asymptomatic cirrhosis patients, mean age 68 years, of which 20 cases of hepatitis B virus surface antigen (HBsAg) positive, 94 cases of anti-HBsAg and / or anti-virus nuclear antibody (Anti-HBc) positive. All patients were admitted to the hospital at the time and thereafter every 6 months to track US and AFP1 times for a total of 2 years. Where the US found to have lesions, are puncture or laparotomy biopsy. Patients diagnosed with HCC were followed up every 3 months for US and AFP was measured. Admission US screening test results found that 13 patients had focal lesions confirmed by biopsy in 10 patients with HCC. Two years of US follow-up examination found that 5 cases of HCC. The 15 cases (male 13, female 2) are early cancer, tumor <5cm. Among them HBsAg positive in 2 cases. The authors found that if AFP> 400ng / ml as HCC diagnostic criteria,