小型肝細胞癌の早期診断-肝切除235症例における病巣検出状況と効果的発見法の検討-

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A total of 235 patients with small hepatocellular carcinomas, all smaller than 5 cm in diameter, underwent hepatectomy during the last 11 years (1977-1987) were retrospectively evaluated to investigate the diagnostic circumstances especially about the first diagnostic clue for tumor detection. In 69 patients (29.4%), serum alpha-fetoprotein (AFP) values were within normal range, and only 64 patients (27.2%) had the values over 400ng/ml. As a whole, the lesions were revealed by abnormal AFP values in 82 patients (34.9%), and by ultrasonography in 112 patients (47.7%). In the first years of the study, AFP served a clue in 63% of 32 patients, but by the end ultrasonography did in 64% of 133 patients. The contribution rates of AFP decreased and those of ultrasonography have been increasing with a statistically significant difference (p<0.01). These findings ascertain that ultrasonography has become to play a leading role instead of AFP in early detection of small hepatocellular carcinomas.
社団法人日本肝臓学会の論文