AFP or CT Scan - diagnostic tool for hepatocellular carcinoma

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02529.x/abstract>

Noninvasive diagnostic criteria for hepatocellular carcinoma in hepatic
masses >2 cm in a hepatitis B virus-endemic area

Sung Eun Kim1, Han Chu Lee1, Ju Hyun Shim1, Hyun Joo Park1, Kang Mo Kim1,
Pyo Nyun Kim2, Yong Moon Shin2, Eun Sil Yu3, Young-Hwa Chung1, Dong Jin
Suh1Article first published online: 11 APR 2011

DOI: 10.1111/j.1478-3231.2011.02529.x
© 2011 John Wiley & Sons A/S
Issue

Liver International
Early View (Online Version of Record published before inclusion in an
issue)

Abstract

Background: Noninvasive criteria for diagnosing hepatocellular carcinoma
(HCC) suggested by the American Association for the Study of Liver Diseases
(AASLD) in 2005 consisted of serum α-fetoprotein (AFP) level >200 ng/ml or
a typical enhancement pattern (arterial enhancement and portal/delayed
washed out) on dynamic imaging of hepatic mass(es) >2 cm in a cirrhotic
liver.

Aims: To validate these criteria in a Korean population and to evaluate
whether these criteria are applicable to patients without cirrhosis at a
high risk of developing HCC.

Methods: We prospectively investigated 206 consecutive patients with
hepatic mass(es) >2 cm who underwent biopsy or surgical resection. Patients
were evaluated by four-phase dynamic computed tomography (CT) and by assays
of serum AFP concentrations at baseline. Patients were classified according
to the presence of risk factors or cirrhosis, and the diagnostic accuracy
of each test was determined.

Results: The positive predictive values (PPV) of typical CT findings or
serum AFP >200 ng/ml were 97.8% in cirrhotic patients, 89.6% in high-risk
patients without cirrhosis and 82.4% in low-risk patients. The PPVs of
typical CT findings alone in these groups were 98.8, 97.6 and 87.5%
respectively. In high-risk patients without cirrhosis, the addition of
serum AFP levels to typical CT findings minimally increased the diagnostic
sensitivity from 81.6 to 87.8% but reduced the PPV from 97.6 to 89.6%.

Conclusions: Serum AFP concentration is not a suitable diagnostic criterion
for HCC. Typical CT findings can be used to diagnose HCC >2 cm both in
cirrhotic patients and in high-risk patients without cirrhosis.




(6.合.彩)足球-篮球...各类投注开户下注

第一投注现金网:招代理-年薪10万以上:6668.cc



(6.合.彩).足球.篮球...各类投注开户下注

第一投注.现金网:招代理年薪10万以上:6668.cc

lin12345

无创诊断标准肝癌肝
群众>在B型肝炎病毒流行区2厘米

宋垠Kim1，韩出Lee1，朱铉Shim1，玄珠Park1，康沫Kim1，
杓Nyun Kim2，雍文Shin2，恩银Yu3，杨骅Chung1，董稽嗯
Suh1Article首次在网上公布：2011年4月11日

分类号：10.1111/j.1478-3231.2011.02529.x
© 2011年约翰Wiley＆Sons出版A / S公司
发行

国际肝病
早期查看（网络版日前发表记录列入一
问题）

摘要

背景：无创诊断肝癌的标准
（HCC）的建议，由美国协会肝病研究
（美国肝病学会）在2005年血清α-胎儿蛋白组成（AFP）水平“200毫微克/毫升或
一个典型的增强模式（动脉加强和门户/延迟
洗出对肝质量（ES）的> 2厘米动态影像）在肝硬化
肝脏。

目的：验证在韩国人口的标准和评估
这些标准是否适用于无肝硬化病人一
肝癌高危发展。

方法：前瞻性研究连续206例
肝肿瘤（ES）的> 2公分谁接受活检或手术切除。患者
的评审工作由四个阶段的动态电脑断层扫描（CT）和检测
血清甲胎蛋白浓度在基线。根据患者进行了分类
其风险因素或肝硬化的存在，以及诊断的准确性
每个测试的决心。

结果：阳性预测值典型的CT表现（PPV）服务或
血清甲胎蛋白“200毫微克/毫升分别为97.8％，在肝硬化患者中，89.6％的高风险
患者无肝硬化和低危患者82.4％。该PPVs的
典型的CT表现在这些团体单独为98.8，97.6和87.5％
分别。在高风险的病人没有肝硬化，前面加个
血清AFP水平，典型的CT诊断结果微创增加
灵敏度从81.6至87.8％，但减少的PPV从97.6到89.6％。

结论：血清AFP浓度是不是一个合适的诊断标准
为肝癌。典型的CT结果可用于诊断肝癌>都在2厘米
肝硬化患者和无肝硬化的高危病人。