Cristani A, Cioni G, De Santis M, Chianese L, Gozzetti G, Ventura E
Clinica Medica III, University of Modena, Italy.
Hepatogastroenterology. 1994 Apr;41(2):137-9.
The case of a 58-year-old man with clinically-stable and compensated HBsAg-positive liver cirrhosis is reported. In April 1991, the patient underwent partial hepatectomy to treat a solitary 3.5 cm hepatocellular carcinoma (HCC), (Edmonson scale I), in the 5th liver segment. His serum alpha-fetoprotein (AFP) level was 24 ng/ml. After hepatectomy, the AFP level dropped to 8 ng/ml, but between the 4th and 12th month it rose gradually from 72 ng/ml to 4,520 ng/ml. Hepatic recurrence of HCC was excluded, but a 6 cm solitary metastasis (Edmonson scale III-IV) was detected on the right adrenal. Adrenalectomy was performed and two months later the patient is doing well and his AFP level is 51 ng/ml. The methodological approach to diagnosis, treatment and follow-up of HCC, and the relationship between AFP and liver and metastatic HCC, are discussed.
报告了一例58岁临床病情稳定且代偿性HBsAg阳性肝硬化男性患者的病例。1991年4月，该患者接受了肝部分切除术，以治疗位于肝Ⅴ段的一个3.5厘米的孤立性肝细胞癌（HCC）（Edmonson分级Ⅰ级）。其血清甲胎蛋白（AFP）水平为24纳克/毫升。肝切除术后，AFP水平降至8纳克/毫升，但在第4至12个月期间，它从72纳克/毫升逐渐升至4520纳克/毫升。排除了HCC肝内复发，但在右侧肾上腺发现了一个6厘米的孤立性转移灶（Edmonson分级Ⅲ - Ⅳ级）。进行了肾上腺切除术，两个月后患者情况良好，其AFP水平为51纳克/毫升。讨论了HCC的诊断、治疗和随访的方法，以及AFP与肝原发和转移性HCC之间的关系。
