Maringhini A, Cottone M, Sciarrino E, Marcenò M P, La Seta F, Rinaldi F, Pagliaro L
Cancer. 1984 Dec 15;54(12):2924-6. doi: 10.1002/1097-0142(19841215)54:12<2924::aid-cncr2820541218>3.0.co;2-f.
A total of 67 cirrhotic patients with clinically suspected neoplastic degeneration and low alpha-fetoprotein levels were assessed prospectively with ultrasound and gold (198Au) scintigraphy. Ultrasound showed space-occupying lesions in 22 of the 24 patients who had a final diagnosis of hepatocellular carcinoma (HCC) (sensitivity, 95.8%) and excluded the presence of HCC in 37 of the 43 patients with cirrhosis only (specificity, 86.0%; efficiency, 90.8%). Scintigraphy demonstrated a cold defect in 22 of the 24 patients who had a final diagnosis of HCC (sensitivity, 95.8%) and excluded the presence of HCC in 22 of the 43 patients with cirrhosis only (specificity, 51.1%; efficiency, 69.8%). It was concluded that the most accurate screening plain in cirrhotic patients suspected of having HCC with alpha-fetoprotein values below 500 ng/ml would consist of ultrasonography followed, as clinically indicated, by ultrasonographic or laparoscopic guided biopsy.
对67例临床怀疑有肿瘤性退变且甲胎蛋白水平较低的肝硬化患者进行了超声和金（198Au）闪烁扫描的前瞻性评估。在最终诊断为肝细胞癌（HCC）的24例患者中，有22例超声显示有占位性病变（敏感性为95.8%）；在仅患有肝硬化的43例患者中，有37例通过超声排除了HCC的存在（特异性为86.0%；效率为90.8%）。闪烁扫描在最终诊断为HCC的24例患者中显示有22例出现冷区缺损（敏感性为95.8%），在仅患有肝硬化的43例患者中，有22例通过闪烁扫描排除了HCC的存在（特异性为51.1%；效率为69.8%）。得出的结论是，对于甲胎蛋白值低于500 ng/ml且怀疑患有HCC的肝硬化患者，最准确的筛查方法是先进行超声检查，然后根据临床指征进行超声引导或腹腔镜引导下的活检。
