Early diagnosis of hepatocellular carcinoma in the patients with hepatic schistosomiasis japonica

山梨医科大学所在的多摩町是日本血吸虫病流行区之一。该地区许多40岁以上的居民都有肝吸虫感染史，并且经常患有门静脉高压症，伴有广泛的肝间质纤维化或钙化。B型肝炎和酒精性肝硬化也是这些居民中的常见病。因此，该地区被认为是肝细胞癌的高危地区。血吸虫病肝脏超声检查发现明显的纤维化或钙化，有时会妨碍无症状肝细胞癌的早期发现。在这种情况下，X线CT是进一步检查的选择。1985年和1986年，我们对本市有肝细胞瘤感染史的居民进行了检查，试图发现这样一个隐匿的肝细胞癌病例。在260例超声检查的居民中， ...更多信息 本文报告1例胃癌肝转移患者和1例胃癌肝转移患者，前者行肝动脉肿瘤栓塞术，后者因大量呕血行胃切除术。1例超声检查疑有肝细胞癌，AFP值高，转诊做进一步检查。本文对73例因超声对肝肿瘤间质纤维化诊断不明确而作X线CT检查的居民，发现2例疑似肝癌，1例疑似肺癌，630例血清AFP阳性者6例，其中2例为同一肿瘤患者。1例为B超检查发现的可疑病例，AFP值高。另3例无肝肿瘤。两年来的经验告诉我们，到目前为止，有效的研究发现肝癌的居民如下。1)对40岁以上人群尽可能进行血清AFP检测; 2）B超筛查肝脏恶性肿瘤; 3）对血吸虫病肝纤维化明显者行X线CT检查。少

Tamahocho, where Yamanashi Medical College is located, was one of the endemic areas of schistosomiasis japonica in Japan. Many inhabitants older than 40 Years of age in this area have histories of schistosomas infection, and are often suffering from portal hypertension with extensive interstitial fibrosis or calcification of the liver. The hepatitis B and alcholic liver cirrhosis are also frequently found among these inhabitants. The area therefore is thought under the high risk condition for the hepatocellular carcinoma. Marked fibrosis or calcification, found in schistosomiasis liver with ultrasonographic examination, some time prevents early detection of silent hepatocellular carcinoma. X-ray CT is the choice of further examination in such a case. In 1985 and 1986, we examined our city inhabitants who have histories of schistomomas infection, and tried to find out such a occult case of hepatocellular carcinoma. Of 260 residents examined by ultrasonography, a patient with hepatocellu … More lar carcinoma and a patient with gastric carcinoma with hepatic metastases were found. The former was treated with hepatic transarterial tumor embolization, and the latter with gastrectomy for his massive hematoemesis. A patient, suspected of hepatocellular carcinoma by ultrasonography and high AFP value, was refered to further examination. Among 73 residents who were examined by X-ray CT in case ultrasonography had given poor information on hepatic tumors because of interstitial fibrosis, 2 patients suspected of hepatocellular carcinoma and a patient suspected of pulmonary carcinoma were found. Among 630 residents whose sera were examined, 6 patients with positive AFP were found. Of them, 2 were happend to be the same patients treated for their cancer, and one was the suspect found by ultrasonography and high AFP value. Another 3 had no hepatic tumors. Two-year experience taught us so far that the effective study of finding hepatocellular carcinoma among those residents are as follows. 1) Serum AFP study for as many residents of more than 40 years of age as possible, 2) screening with ultrasonography in detecting hepatic malignancy, and 3) X-ray CT in detecting hepatic malignancy for those who displayed marked hepatic fibrosis of schistosomiasis. Less