GROWTH-RATE OF ASYMPTOMATIC HEPATOCELLULAR-CARCINOMA AND ITS CLINICAL IMPLICATIONS
GROWTH-RATE OF ASYMPTOMATIC HEPATOCELLULAR-CARCINOMA AND ITS CLINICAL IMPLICATIONS
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DOI：
10.1016/0016-5085(85)90324-5
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发表时间：
1985-01-01
期刊：
影响因子：
29.4
通讯作者：
LEE, CZ
中科院分区：
文献类型：
--
作者：
SHEU, JC;SUNG, JL;LEE, CZ
通过前瞻性筛查计划在 28 名患者中发现的 31 例无症状肝细胞癌（直径≤5 厘米）的生长率通过实时超声检查在 36-860 天内确定。除一例肿瘤随随访缩小外，倍增时间为29至398天，中位时间为117天，算术平均值为136天，几何平均值为110天。在进行两次以上测量的 17 个肿瘤中，有 9 个肿瘤的生长速度保持指数增长，有 7 个肿瘤的生长速度下降，有 1 个肿瘤表现出初始滞后期。倍增时间与初始肿瘤直径相关，但与患者的年龄、性别、乙型肝炎表面抗原状态、肿瘤位置、肝功能测试、肝硬化阶段、组织学类型或恶性肿瘤级别无关。尽管初始甲胎蛋白水平与生长速率没有很好的相关性，但在14名血清甲胎蛋白呈指数增加的患者中，甲胎蛋白倍增时间与肿瘤倍增时间密切相关。综合以上数据推算，肝细胞癌的中位可检出亚临床期为3.2年，本地区早期发现肝细胞癌的适宜筛查间隔为4-5个月。
The growth rate of 31 asymptomatic hepatocellular carcinomas (diameter .ltoreq. 5 cm) discovered in 28 patients by a prospective screening program was determined by real-time ultrasonography over 36-860 days. Except for one tumor that shrank on follow-up, the doubling time ranged from 29 to 398 days, with a median of 117 days, an arithmetic mean of 136 days, and a geometric mean of 110 days. In 17 tumors with more than two measurements, the growth rate remained exponential in nine, declined in growth in seven, and showed an initial lag period in one. Doubling time correlated with initial tumor dimeter but was independent of the patient''s age, sex, hepatitis B surface antigen status, tumor location, liver function tests, stage of liver cirrhosis, histologic type, or grade of malignancy. Although initial .alpha.-fetoprotein levels did not correlate well with growth rate, in 14 patients with an exponential increase of serum .alpha.-fetoprotein, the .alpha.-fetoprotein doubling time was closely related to the tumor doubling time. Based on the above data, the median detectable subclinical period of hepatocellular carcinoma was deduced to be 3.2 yr, and the suitable screening interval for its early detection in our area was 4-5 mo.