간세포암 선별검사로서 정기적인 초음파 및 α-fetoprotein 검사의 유용성

초록

Background/Aims : Periodic follow-up with abdominal ultrasonography and/or α-fetoprotein (AFP) assay has been used for the early detection of hepatocellular carcinoma (HCC). However, its effectiveness is still controversial. The aim of this study was to re-evaluate the effectiveness of these follow-up methods. Methods: Five hundreds and thirty patients with HCC were divided into two groups: follow- up group with regular screening (n=81) and non follow-up group without screening (n=449). According to the interval of checkup, the follow-up group was divided into three subgroups: FU-1 group (<3 months), FU-2 group (4-6 months), FU-3 group (7-12 months). Results : The rate of early detection (58% vs 27% in the detection of the single nodular type), median survival (48 months vs 6 months) and therapeutic trial (91% vs 60%) were higher in the follow-up group than in the non follow-up group. The diameter of the largest tumor in each group was 3.4±2.3 cm and 9.0±5.0 cm, respectively. As screening methods, abdominal ultrasonography combined with AFP assay was superior to AFP assay alone or abdominal ultrasonography alone. There were no significant differences in type and size of the tumor and the survival rate among three follow-up subgroups. Conclusions: Periodic follow-up with abdominal ultrasonography and/or AFP assay enabled the early detection of HCC and improved its prognosis and survival.

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