Sherman Morris
Department of Medicine, University of Toronto and University Health Network, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
Curr Gastroenterol Rep. 2005 Feb;7(1):11-8. doi: 10.1007/s11894-005-0060-7.
The advent of screening programs for hepatocellular carcinoma in patients with chronic viral hepatitis and cirrhosis has resulted in detection of smaller and smaller lesions in the liver. Some of these are small carcinomas, but many are not malignant in nature or are potential precursors to malignancy. Neither radiology nor biopsy can be used confidently to distinguish between these possibilities when the lesions are smaller than approximately 1.5 cm in diameter. Therefore, diagnostic algorithms must be developed to assist physicians in investigating these small lesions and deciding when they are truly malignant, when treatment is necessary, or whether a watchful waiting course is appropriate. The diagnostic difficulties are presented, with examples of diagnostic algorithms that may be helpful in managing these patients.
针对慢性病毒性肝炎和肝硬化患者的肝细胞癌筛查项目的出现，已导致在肝脏中检测到越来越小的病变。其中一些是小癌，但许多并非恶性，或为恶性肿瘤的潜在前体。当病变直径小于约1.5厘米时，放射学检查和活检都无法可靠地区分这些可能性。因此，必须开发诊断算法，以协助医生对这些小病变进行调查，并确定它们何时真正为恶性、何时需要治疗，或观察等待过程是否合适。本文介绍了诊断困难，并列举了可能有助于管理这些患者的诊断算法示例。
