Imberti D, Fornari F, Sbolli G, Buscarini E, Squassante L, Buscarini L
First Dept. of Internal Medicine, Piacenza Hospital, Italy.
Scand J Gastroenterol. 1993 Jun;28(6):540-4. doi: 10.3109/00365529309098263.
From January 1984 to December 1991 we carried out a prospective surveillance of the development of hepatocellular carcinoma (HCC) in 200 cirrhotic patients, monitored from the first histologic diagnosis of cirrhosis. Real-time ultrasonography (US) and serum alpha-fetoprotein (AFP) assays were performed every 3-6 months. During this period we detected HCC in 38 patients. The overall cumulative incidence of HCC in the 8 years was 41%, with a yearly incidence of 5.1%. Eighteen of 38 patients (48%) had a tumor < 5 cm in diameter. AFP reached diagnostic levels (> 500 ng/ml) in eight cases only (21%). Patients with initial AFP values > 20 ng/ml developed HCC more frequently than patients with values < or = 20 ng/ml; the percentage of HCC was statistically higher (p < 0.01) in patients in Child's B and C than in Child's A class. A periodic follow-up, using US and AFP, is suggested for the early diagnosis of HCC in cirrhotic patients.
1984年1月至1991年12月，我们对200例肝硬化患者进行了肝细胞癌（HCC）发生情况的前瞻性监测，自首次肝硬化组织学诊断起开始监测。每3至6个月进行一次实时超声检查（US）和血清甲胎蛋白（AFP）检测。在此期间，我们在38例患者中检测到了HCC。8年期间HCC的总体累积发病率为41%，年发病率为5.1%。38例患者中有18例（48%）肿瘤直径<5 cm。AFP仅在8例（21%）中达到诊断水平（>500 ng/ml）。初始AFP值>20 ng/ml的患者发生HCC的频率高于AFP值≤20 ng/ml的患者；Child's B级和C级患者中HCC的百分比在统计学上高于Child's A级患者（p<0.01）。建议对肝硬化患者进行定期随访，采用超声检查和AFP检测以早期诊断HCC。
