Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma

Article Abstract:

Hepatocellular carcinoma (liver cancer) has a very poor prognosis. However, surgical resection of the tumor may result in long-term survivors; such surgical treatment is usually impossible by the time the symptoms of the tumor develop. Therefore, it is critical that liver cancer be diagnosed while it is still in the asymptomatic stage. Ultrasonic imaging techniques provide a method for visualizing liver cancer in its early stages. While clinicians are attempting mass screening, others feel it is more practical to limit screening to patients with liver disease who are at especially high risk for liver cancer. To evaluate the usefulness of ultrasonography for the early diagnosis of liver cancer in a high risk population, a total of 2,004 examinations were performed on 660 patients with liver disease. One hundred seventy-nine patients had liver cirrhosis and 481 had chronic hepatitis. A total of 21 cases were diagnosed as definite liver cancer by ultrasonography; 13 cases were histologically confirmed to be so. Similarly, 8 of 32 cases diagnosed as probable liver cancer were also confirmed. The cases that appeared to be liver cancer, but were not confirmed, continue to be monitored periodically. A total of 22 confirmed cases of hepatocellular carcinoma were identified, and surgical resection of the cancer was performed in 12 cases. Seventeen of the 22 cases occurred among the cirrhosis patients, a rate of 9.6 percent; five were diagnosed in the hepatitis cases, for a rate of 1.0 percent among these patients. This rate of identification of cases appropriate for surgery suggests that ultrasonography is appropriate for the screening of patients with liver disease, particularly cirrhosis, for the development of liver cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ultrasound imaging, Diagnosis

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Estimation of validity of mass screening program for gastric cancer in Osaka, Japan

Article Abstract:

In Japan, stomach cancer has a higher mortality rate than any other cancer. Indeed, the mortality rate for stomach cancer in Japan is greater than that of any cancer anywhere in the world. The annual death rate for stomach cancer in Japan is 56 per 100,000 for men and 28 per 100,000 for women. The seriousness of the problem has prompted interest in a mass screening program for early diagnosis. Three techniques for mass screening are available: direct radiography (conventional X-ray), photofluorography with an image intensifier, and photofluorography with a mirror camera. In photofluorography, the X-rays project a fluoroscopic on a screen, which is photographed on a roll of film. While in principle, direct radiography must be superior to photofluorography with a 100 mm camera, the camera is much more efficient for mass screening. It is therefore important to determine just how effective the three screening tests are. In an analysis of 272,667 screening tests performed on 105,122 individuals, the use of am image intensifier on a 100 mm camera was found to produce results which were virtually identical to those achieved with conventional X-ray films. Both are superior to the use of the mirror camera. A general overview of the screening program indicates that it compares well with other screening programs, such as for breast cancer, in its ability to detect cancer. However, the specificity of the detection is inferior to some other programs; that is, a positive sign on the stomach cancer screening is less likely to actually represent a malignancy than is a positive sign on some other types of mass screening programs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Japan, Cancer, Medical screening, Health screening, Stomach cancer, Osaka

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Risk factors for hepatocellular carcinoma among patients with chronic liver disease

Article Abstract:

Infection with the hepatitis C virus appears to greatly increase the risk of liver cancer. Of 917 patients aged 40 to 69, 240 had cirrhosis of the liver and 677 had chronic hepatitis. At the time of enrollment between 1987 and 1991, none of the patients had liver cancer. However by Sep 1991, 54 patients had developed liver cancer. Twenty-eight of the patients initially diagnosed with liver cirrhosis developed liver cancer, and the other 26 were initially diagnosed with chronic hepatitis. Patients whose blood tested positive for hepatitis B surface antigen were 6.9 times more likely to develop cancer. Those whose blood tested positive for antibodies to the hepatitis C virus were four times more likely to develop liver cancer. Elevated levels of the blood protein alpha-fetoprotein were also associated with an increased risk of developing liver cancer. Among patients initially diagnosed with liver cirrhosis, smoking and heavy drinking increased the risk of liver cancer.

Risk factors, Hepatitis C, Hepatitis B

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