Tumor markers are more useful in patients undergoing surveillance for hepatocellular carcinoma with unreliable results by ultrasonography.
Tumor markers are more useful in patients undergoing surveillance for hepatocellular carcinoma with unreliable results by ultrasonography.
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肿瘤标志物对于接受肝细胞癌监测且超声检查结果不可靠的患者更有用。
DOI：
10.1111/hepr.12365
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Koike K.
中科院分区：
文献类型：
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作者：
Mikami S;Tateishi R;Hagiwara S;Sato M;Minami T;Uchino K;Enooku K;Sato T;Nakagawa H;Masuzaki R;Asaoka Y;Kondo Y;Shiina S;Ikeda H;Omata M;Yoshida H;Koike K.
目的探讨肿瘤标志物在肝细胞癌(简称肝癌)监测中的应用价值。方法对2000年2月至2010年12月通过超声联合三种肿瘤标志物监测发现的313例肝细胞癌患者进行分析。根据触发事件，患者被分成两组：US组(n= 281)和TM组(n= 32)，在US组中，通过超声首次发现肿瘤；在TM组中，肿瘤标志物升高导致诊断出超声无法检测到的肿瘤。根据三项指标(肝实质粗糙度、患者肥胖和肝萎缩)对超声检查的可靠性进行4分评分。结果肿瘤的中位大小为20 mm(四分位数范围15-24)。超声检查结果：良208例(66.5%)，满意80例(8.0%)，差21例(6.7%)，不满意4例(1.2%)。TM组患者所占比例明显增加，从7.2%上升到25.0%(P= )。3年和5年 生存率US组分别为83.7%和57.2%，TM组分别为79.3%和59.4%(P= 0.98)。结论肿瘤标志物对超声结果不可靠的患者有一定的诊断价值。肿瘤标志物升高诊断的患者与超声诊断的患者的存活率没有显著差异。
AimThe objectives of this study was to evaluate the utility of tumor markers in hepatocellular carcinoma (HCC) surveillance based on the reliability of ultrasonography.MethodsWe analyzed 313 patients with HCC detected through a surveillance program using ultrasonography combined with three tumor markers from February 2000 to December 2010. The patients were categorized into two groups based on the triggering event: the US group (n= 281) in which a tumor was first detected using ultrasonography and the TM group (n= 32) in which elevated tumor markers led to the diagnosis of a tumor that was undetected using ultrasonography. The reliability of ultrasonography was scored on a 4‐point scale based on three items (coarseness of liver parenchyma, patient obesity and liver atrophy). Additionally, patient survival was assessed using the Kaplan–Meier method and log–rank test.ResultsThe median tumor size was 20 mm (interquartile range, 15–24). The reliability of ultrasonography was evaluated as good in 208 (66.5%), satisfactory in 80 (8.0%), poor in 21 (6.7%) and unsatisfactory in four (1.2%) patients. The proportion of patients in the TM group increased significantly according to the score, from 7.2% to 25.0% (P= 0.01). The survival rates of patients at 3 and 5 years were 83.7% and 57.2% in the US group, and 79.3% and 59.4% in the TM group, respectively (P= 0.98).ConclusionTumor markers may play a diagnostic role in patients with unreliable ultrasonography results. The survival of patients diagnosed by elevated tumor markers was not significantly different from those diagnosed by ultrasonography.