PATHOLOGICAL STUDIES ON PRIMARY CARCINOMA OF THE LIVER : A STUDY OF 89 CASES AMONG 3890 NECROPSIES AND A STUDY OF ALPHA-FETOPROTEIN IN THE SERUM OF 17 CASES.
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1. Eighty-nine primary liver cancers were noted among 3890 necropsies performed at Kurume University School of Medicine, in the period 1929-1971, a frequency of 2.28 per cent.2. The sex ratio of male to female was thus 7 : 1. The average age was 57.26±11.82 years. The average age for male was 56.96±11.77 years and for female 59.60±10.76 years. Agewise, the largest frequency was in the sixth decade in life.3. General malaise was the most common as an initial symptom. Abdominal pain, ascites, enlargement of the liver, icterus, and fullsensation of the abdomen were prominent symptoms in the course of primary liver cancer. The average survival time was very short compared with other malignant tumors. About fifty per cent of patients died within three months after the appearance of initial symptoms.4. Bleeding from digestive organs including esophageal varices and tumor, and hepetic coma were frequent as a cause of death.5. Ascites was seen in 86 per cent and icterus was seen in 67.3 per cent of all cases. Association of liver cirrhosis somewhat effected liver and spleen weight.6. Metastasis was relatively rare compared with other malignant tumors, a frequency of 59.6 per cent. The lungs were the most frequent recipients (42.7%).7. The gross classification of primary liver cancer was carried out as follows; nodular form, massive form, and diffuse form.8. Histologically, the fifty-seven liver cell carcinomas were classified into trabecular, glandular, mixed type of trabecular and glandular; giant cell carcinoma, and small cell carcinoma. Seven cases of bile duct carcinoma and one case of combined carcinoma were observed.9. Most frequent associted lesion was liver cirrhosis and most of associated liver cirrhosis were Miyakes B type. Gastroduodenal ulcer and gastric erosion were observed in 30.3 per cent of all cases. Thirteen of the 89 primary liver cancers were associated with schistosomiasis japonica, but no causal relationship could be histologically found.10. Detection of alpha-f etoprotein was carried out in recent seventeen cases. Alpha-fetoprotein was positive in eleven cases but negative in six cases. No marked relationship between alpha-fetoprotein and histological findings could be found.
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