Hepatocellular Carcinoma: The Role of Screening.
Objective: To determine whether screening can lead to early detection of hepatocellular carcinoma (HCC) and improvement of long-term outcome. Methods: Alpha-fetoprotein (AFP) serosurvey plus ultrasonography have been employed as the principal screening approach for early detection of subclinical HCC. Results: During January 1971-December 1997, 2742 patients with pathologically proven HCC were retrospectively reviewed. Comparison between screening patients(n=1019) and clinical patients(n=1723), revealed the former to have a higher proportion of subclinical stage(74.1% vs 5.3%), a smaller tumor size (<;5cm, 52.1% vs 17.8%), a higher proportion of single tumors (71.6% vs 55.4%), a higher proportion of encapsulated tumors(65.5% vs 43.1%), a lower proportion of tumor emboli in the portal vein (6.8% vs 10.8%), a lower r-GTP level (<6 units, 44.5% vs 28.3%), a lower preoperative AFP level(<400ng/ml, 30.0% vs 25.0%), a higher resection rate (81.1% vs 58.0%), a higher radical resection rate(72.4% vs 66.6%), a lower operative mortality rate (2.5% vs 4.8%), a higher postoperative normalization of AFP level (37.5% vs 24.0%) and higher survival rates (5-year, 49.9% vs 32.5%; 10-year, 34.4% vs 24.0%). Conclusions: The significance of the role of screening for HCC is clear. It provides a hopeful chance of cure of HCC, has proven to be an important approach to improve overall prognosis, and has also led to changing concepts in clinical research into HCC.
Zhou
Xin Da
XD
Liver Cancer Institute, Zhong Shan Hospital, Shanghai Medical University, Shanghai 200032, China.
Tang
Zhao You
ZY
Yang
Bing Hui
BH
Zhang
Bo Heng
BH