Sonographic screening for hepatocellular carcinoma in patients with chronic hepatitis or cirrhosis: an evaluation
| Autor: | G Berry, G C Farrell, H Sorokopud, George Larcos |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Cirrhosis Cost-Benefit Analysis Sensitivity and Specificity Gastroenterology Liver disease Hepatitis B Chronic Chronic hepatitis Liver Cirrhosis Alcoholic Internal medicine Biopsy Humans Mass Screening Medicine Radiology Nuclear Medicine and imaging In patient Aged Ultrasonography Hepatitis medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Liver Neoplasms General Medicine Hepatitis C Chronic Middle Aged medicine.disease digestive system diseases Evaluation Studies as Topic Hepatocellular carcinoma Female business |
| Zdroj: | American Journal of Roentgenology. 171:433-435 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.171.2.9694470 |
| Popis: | The purposes of this study were to determine the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis or cirrhosis and to assess the cost and benefit of sonographic screening for HCC.We reviewed 647 sonograms of 232 patients obtained over an 8-year period. One hundred fifty-two patients had at least two sonograms. One hundred fifty-four men and 78 women with a mean age of 51 years were included. Most patients (n = 207) had biopsy-proven cirrhosis. Ethnicity, age, gender, type of liver disease, and alpha-fetoprotein levels were analyzed to determine factors associated with HCC detection. The costs of sonography and other tests were calculated using the Australian government Medicare benefits schedule.Thirty-one patients (13%) had elevated alpha-fetoprotein levels. Liver masses were found in 25 (11%) patients. Six (2.6%) patients had HCC on biopsy (n = 3) or other tests. All cases of HCC were inoperable because of tumor multicentricity or metastases (n = 2) or both, or because of the relatively large size or poor physical condition of the patient (n = 4) or both. The only variable associated with detection of HCC was alcohol-related liver disease (p = .01). Of the six patients with HCC, one had an elevated alpha-fetoprotein level. The yearly incidence of HCC was 1.4%. Other masses shown by sonography included regenerating nodules (n = 5), hemangiomas (n = 5), focal fat sparing (n = 4), metastases (n = 2), and other lesions (n = 3). No patient underwent surgical resection, which precluded calculation of a survival benefit. The cost of our screening program was $8472 (United States dollars) per HCC. CONCLUSION. Sonographic screening is superior to alpha-fetoprotein assay for detection of HCC, but in this study, screening did not decrease mortality. |
| Databáze: | OpenAIRE |
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