DETECTION OF HEPATOCELLULAR CARCINOMA DURING A CLINICAL FOLLOW-UP OF CHRONIC LIVER-DISEASE - OBSERVATIONS IN 31 PATIENTS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 74  (3) , 578-582
Abstract
In 31 patients with an initial diagnosis of cirrhosis or chronic hepatitis hepatocellular carcinoma (HCC) was detected after a clinical follow-up of 8 mo. to 14 yr with an average of 59 mo. They had no scintigraphic and biochemical abnormalities suggestive of HCC at the beginning. The follow-up period before detection of carcinoma was shorter in patients positive for hepatitis B surface antigen compared with those negative for hepatitis B surface antigen. Analyses of clinical data during follow-up and liver scans made shortly before tumor detection suggested that in most of these patients HCC became discernible relatively early in the course of cirrhosis or long before cirrhosis reached an advanced stage. A sharp rise in serum .alpha.-fetoprotein level proved highly diagnostic in 11, it remained low throughout in 7 and tumor was already unresectable in the majority. Although continuous and regular checks for .alpha.-fetoprotein are imperative in patients with chronic liver disease, particularly in those with hepatitis B surface antigenemia, additional diagnostic tools are necessary for the detection of small HCC in its resectable stage.