Surgical treatment of primary hepatoeellular carcinoma: a 20-year clinical experience in 7566 patients / 中华消化外科杂志

Objective To summarize the clinical experienee in surgical treatment for hepatocellular carcinoma (HCC). Methods The clinical data of 7566 HCC patients who had been admitted to Research Institute of Liver Cancer of Fudan University from January 1988 to Deeember 2007 were retrospectively analyzed. The overall survival and recurrence free survival (RFS) rates were eaeulated with Kaplan-Meier survival curve. All the data were analyzed using Log-rank test and Cox regression model. Results The 3-, 5-, 10-year overall survival and RFS rates of 7164 patients with HCC resection were 56.29%, 41.76%, 26.70%, and 63.92%, 56.12%, 42.97%, respectively, and the perioperative mortality was 1.54%. The 5- and 10-year overall survival rates of patients with small HCC (diameter<5 era) were 58.20% and 38.47%, which were significantly higher than 31.42% and 20.43% of patients with large HCC (diameter >5 cm) (X2 =535. 568, P <0.01). The 5-year overall survival rotes of HCC patients with resection after down-staging (n = 110), re-resection after recurrence (n = 515), and tumor thrombus in portal vein (n = 168) were 51.26%, 67.28% and 26.81%, respectively; nd the 5-year DFS rotes were 77.44%, 13.01% (calculated from the first operation) and 34.90%, respectively. The 3- and 5-year overall survival and DFS rates of 402 patients who had undergone liver transplantation were 60.81%, 55.63% and 64.47%, 58.52%. The independent prognostic factors influencing the overall survival and DFS rates were the size, number and differentiation of HCC and intrahepatic vessel invasion (X2 = 200.539, 27. 536, 96.964,216. 156, P <0.01). Conclusions Early screening, improved safety of surgery, combined therapy and breakthrough in the reseaeh of preventing HCC metastasis and reeurrenee will significantly improve the treatment outcome of HCC.

Heptocellular carcinoma with serum AFP level in 21μg/L to 200 μg/L / 中国普通外科杂志

Objective　To introduce clinical diagnostic specificity of hepatocellular carcinoma (HCC) with serum AFP level in 21μg/L to 200μg/L. Methods　Making a literature summarizaton based on the papers review.Results and Conclusions　(1) The AFP level more than 20μg/L can be used as a diagnostic criteria of HCC when existing liver space occuping lesion (SOL). (2) The clinical diagnostic criteria using AFP level more than 20 μg/L instead of more than 200 μg/L would be helpful to avoid misdiagnosis of HCC with the AFP level in 21 μg/L to 200 μg/L. (3) The Combination of AFP level more than 20 μg/L with ultrasonography, CT scanning would have higher sensitivity and specificity than single diagnostic method.

Focal nodular hyperplasia of the liver: a report of 60 cases / 中国普通外科杂志

Objective To evaluate the diagnosis and treatment of focal nodular!hyperplasia of the liver (FNH). Methods Retrospective analysis was made on 60 FNH cases in terms of clinical findings, images, pathologic examination and surgical treatment. Results Of the 60 FNH patients in our hospital from 1993 to 2003, 41 were male and 19 female. The average age was 37 year′s old. Fifty-five cases had single focus, the other five were of multiple lesion, with tumor diameter 10cm in one. Correct preoperative diagnosis was made in 33 cases (55%). The correct diagnostic rate of BUS, CT and MRI was 33.3%, 58.3% and 72.0%, respectively. All 60 cases underwent operation with an uneventful recovery and without recurrence at follow-up. ConclusionsCT and MRI are mandatory for the diagnosis of FNH. Definite preoperative diagnosis is usually difficult even in cases of typical type of FNH. Surgical resection is the treatment of choice when a patient becomes symptomatic or when malignancy could not be excluded.

The diagnosis of hepatocellular carcinoma with low positive serum AFP level: an analysis of 424 cases / 中国普通外科杂志

ObjectiveTo investigate the value of low positive AFP level for the diagnosis of hepatocellular carcinoma (HCC) when a space occuping lesion (SOL) was already identified in the liver.MethodsUsing randomized controlled clinical trial,a clinical epidemiological analysis was made based on the result of surgery and pathology proven hepatic SOL of 2?878 cases admitted from January 1993 to June 2001.In this series,there were 2?362 HCC cases, among which 424 HCC cases were with a low positive AFP level(between 21 and 200??g/L) which constitutes the basis of our analysis.ResultsIn HCC and non HCC groups,the sensitivity,specificity and positive predictive value were 69 9%(1?650/2?362) vs.8 9%(46/516) ( P

Heptocellular carcinoma with serum AFP level in 21?g/L to 200 ?g/L / 中国普通外科杂志

Objective To introduce clinical diagnostic specificity of hepatocellular carcinoma (HCC) with serum AFP level in 21*!?g/L to 200*!?g/L. Methods Making a literature summarizaton based on the papers review.Results and Conclusions (1) The AFP level more than 20*!?g/L can be used as a diagnostic criteria of HCC when existing liver space occuping lesion (SOL). (2) The clinical diagnostic criteria using AFP level more than 20 ?g/L instead of more than 200 ?g/L would be helpful to avoid misdiagnosis of HCC with the AFP level in 21 ?g/L to 200 ?g/L. (3) The Combination of AFP level more than 20 ?g/L with ultrasonography, CT scanning would have higher sensitivity and specificity than single diagnostic method.