Tang Z Y
Ann Acad Med Singap. 1980 Apr;9(2):234-9.
The discovery of tumor marker alpha-foetoprotein (AFP) in hepatocellular carcinoma (HCC) and its application in screening has greatly contributed to early diagnosis. Of the more than five million natural population screened in our country since 1971, over one thousand cases of HCC have been detected. The percentage of subclinical cancer has been increased to 60.7% since passive reverse hemagglutination test was employed as initial screening in 1974. Diagnosis of subclinical HCC by AFP depends upon its absolute value, its serial change and interrelationship between serial change of AFP and SGPT. Subclinical HCC only amounted to 0.4-0.9% in clinical cases, but it went up to 44.7-71.2% in mass survey patients. Small HCC also rarely occurred in literature, however, the number of cases of small HCC resected has exceeded one hundred in our country, it amounting to 56.8-72.7% of the resected cases in mass survey patients. Results of a comparative study of mass survey and clinical patients demonstrated that 1-year, 2-year and 3-year survival being 14.8%, 7.4% and 5.5% and in clinical patients; 45.2%, 16.4% and 4.1% in mass survey patients who received conservative treatment; and 79.1%, 67.8% and 61.6% who received surgical resection. Unsolved problems and future prospects were also discussed.
肿瘤标志物甲胎蛋白（AFP）在肝细胞癌（HCC）中的发现及其在筛查中的应用对早期诊断有极大贡献。自1971年以来，我国对500多万自然人群进行了筛查，已检测出1000多例HCC病例。自1974年采用被动反向血凝试验作为初筛以来，亚临床癌的比例已增至60.7%。通过AFP诊断亚临床HCC取决于其绝对值、其系列变化以及AFP系列变化与谷丙转氨酶（SGPT）之间的相互关系。亚临床HCC在临床病例中仅占0.4 - 0.9%，但在大规模普查患者中升至44.7 - 71.2%。小肝癌在文献中也很少见，然而，我国已切除的小肝癌病例数已超过100例，占大规模普查患者切除病例的56.8 - 72.7%。对大规模普查患者和临床患者的比较研究结果表明，临床患者的1年、2年和3年生存率分别为14.8%、7.4%和5.5%；接受保守治疗的大规模普查患者分别为45.2%、16.4%和4.1%；接受手术切除的患者分别为79.1%、67.8%和61.6%。文中还讨论了未解决的问题和未来前景。
