Clinical findings of patients with liver cirrhosis and minute hepatocellular carcinoma in rural district / 日本農村医学会雑誌

ABSTRACT

During the past five years, 141 cases of liver cirrohosis were hospitalized intoour clinic. The mean age of these patients was 57.8 years old, and the ratio of male to female was 2.8 to 1. HBs antigen was positive in 16 cases, and among the patients without HBs antigen 49 cases of heavy alcoholic drinker were found. Seventy patients with liver cirrhosis were dividedinto a compensatory group and a decompensatory group according to three clinical findings, ascites, hepatic encephalopathy and bleeding from gastrointestinal tract. It was suggested that five items of biochemical data for liver function were very important on discriminating these two groups. The five items were cholinesterase, indocyanine green test, albumin, prothrombin time and erythrocyte count.<BR>Next, we studied clinical findings of eight patients with minute hepatocellular carcinoma hospitalized into our clinic during the past five years. About a definition of minute hepatocellular carcinoma, we have defined that the tumor size should be less than 3 cm in diameter. Six of these patients were male, and average age was 56.7 years old. Of these patients, five were complicated by liver cirrhosis, and only one revealed positive HBs antigen in serum. The serum alpha-fetoprotein level showed more than 400 ng/ml in three patients. And we have thought that ultrasonographic examination is most effective to diagnose minute hepatocellular carcinoma in various diagnostic imaging methods. Most of patients exhibited a decreased functional reserve in the liver, but six patients underwent hepatic resection. After operation, one patient died of acutehepatic insufficiency on the 8th day, and one died of the recurrence of tumor on the 11th month. Otherfour patients have been alive now.