ABSTRACT
Mass screening for liver cancer based mainly on abdominal ultrasound was begun in major cities of Hokkaido, Japan, in November 1981, to enable early detection and treatment of hepatocellular carcinoma (HCC). Serum alpha-fetoprotein levels were also measured to minimize false negative studies. Examinees included those who sought liver disease screening as well as high risk individuals: hepatitis B surface antigen carriers and those with a past or current liver disease, history of blood transfusion, family history of liver cancer, and more recently those with positive anti-hepatitis C antibodies. The examination was carried out on each Saturday and Sunday as one round, and by February 1992 48 rounds had been performed. A total of 8090 individuals were investigated, and HCC was detected in 91 with a detection rate of 1.12%. This rate was 1.6% among 5684 individuals who were selected for high risk. Cumulative rates of survival among these patients were 79.0% at 1 year, 43.8% at 3 years, 19.3% at 5 years and 15.4% at 7 years. These survival rates were comparable with those for the patients with HCC diagnosed during follow-up of chronic liver disease and treated at our hospital. The cost for detecting one HCC patient in this programme was 2,660,000 yen (approximately US$25,000), which was less than those for some other types of cancer in a similar setting. Considering the high detection rate in this programme, we feel that similar programmes should be encouraged and supported.
Subject(s)
Carcinoma, Hepatocellular/prevention & control , Liver Neoplasms/prevention & control , Mass Screening/methods , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/epidemiology , Costs and Cost Analysis , False Negative Reactions , Female , Follow-Up Studies , Humans , Japan/epidemiology , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/epidemiology , Male , Mass Screening/economics , Middle Aged , Risk Factors , Survival Rate , Ultrasonography , alpha-Fetoproteins/analysisABSTRACT
A hyperplastic nodular lesion resembling focal nodular hyperplasia (FNH) was found in the cirrhotic liver of a 50-year-old male patient. A nodule was detected by ultrasonography and hepatic angiography conducted as part of a routine follow-up study for chronic liver disease, and was excised under a diagnosis of suspected hepatocellular carcinoma. Grossly, central stellate scar-like septa subdividing the nodule ware noted. These fibrous septa contained many small arteries and veins, as well as bile ducts. The parenchyma of the nodule also contained many small arteries. Although these findings were similar to those seen in typical FNH, the present lesion was different in that it was encapsulated, occurred against a background of liver cirrhosis, lacked hepatocyte hyperplasia and showed hemosiderin deposition.
