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Screening for hepatocellular carcinoma in patients with Child's A cirrhosis: an 8-year prospective study by ultrasound and alphafetoprotein
- Source :
- Journal of Hepatology. 21:1029-1034
- Publication Year :
- 1994
- Publisher :
- Elsevier BV, 1994.
-
Abstract
- One hundred and forty-seven patients with Child's A cirrhosis and no evidence of hepatocellular carcinoma were followed up in an 8-year prospective surveillance program with testing by ultrasound and alphafetoprotein every 6 months. Eighteen of 147 patients were HBsAg positive. Anti-hepatitis C virus antibodies were found in 103 out of 133 cases tested. Sixteen patients had a history of heavy drinking. Thirty hepatocellular carcinomas were detected during follow up. At the time of diagnosis, ultrasound detected focal lesions in all the patients whereas alphafetoprotein was below diagnostic levels. The hepatocellular carcinoma was single in 26 patients and multiple in four. The overall 8-year cumulative tumor-free rate was 69% (95% confidence interval = 58-73). The yearly hepatocellular carcinoma incidence from 1985 to 1992 was respectively 2%, 1.5%, 2%, 3%, 5%, 4.8%, 7% and 10%. The initial value of AFP50 ng/ml and400 ng/ml was significantly related to the development of hepatocellular carcinoma. This series shows that the cumulative incidence of hepatocellular carcinoma in cirrhosis in Italy is higher than previously reported, but lower than that observed in Asiatic areas. A 6-month interval for ultrasound is reasonable to detect treatable tumors. Alphafetoprotein has no value for early diagnosis, although its intermediate values (50 and400 ng/ml) may indicate the presence of undetectable cancer which will appear during the follow up, and suggests that ultrasound should be employed more frequently in patients with these values.
- Subjects :
- Liver Cirrhosis
Male
HBsAg
medicine.medical_specialty
Carcinoma, Hepatocellular
Cirrhosis
Gastroenterology
Internal medicine
medicine
Carcinoma
Humans
Mass Screening
Longitudinal Studies
Prospective Studies
Prospective cohort study
Aged
Ultrasonography
Hepatology
Epithelioma
business.industry
Incidence
Incidence (epidemiology)
Liver Neoplasms
Middle Aged
medicine.disease
Survival Analysis
Confidence interval
Hepatocellular carcinoma
Female
alpha-Fetoproteins
business
Subjects
Details
- ISSN :
- 01688278
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Journal of Hepatology
- Accession number :
- edsair.doi.dedup.....9e9765ea81992438e876734bdbe0e371