筛查与肝癌的早期诊断

Screening and early diagnosis of primary liver cancer

目的研究筛查对肝癌早期诊断的价值。方法将１８８１６名肝癌高危对象随机分为筛查组与对照组。筛查组每６个月作一次ＡＦＰ与实时超声检查。对照组不做主动检查。结果筛查组５年共检出肝癌８６例，其中早期（Ｉ期）占６０．５％、小肝癌占４５．３％。对照组５年共发生肝癌引例，无１例早期或小肝癌病例，差异非常显著（Ｐ＜０．０１）。筛查检出之肝癌病例中，５７例为经过１次或多次阴性检查后，在继续的定期检查中检出之病例，其中早期更高达７７．２％。而未经阴性检查“保护”的２９例筛查检出之病例中只有２７．６％为早期，差异非常显著（Ｐ＜０．０１）。结论筛查为肝癌早期诊断的前提。尤其在一定的人群中进行定期筛查，才能更有效地达到早期诊断的目的。

Objective To investigste the value of screening for early diagnosis of primary livercancer (PLC). M.thods A total of 18 816 persons, who were high--risk population of PLC, were dividedrandomly to allocated screening group and control group. In the screening group every individual waschecked up by serum AFP test and ultrasound every 6 months but those in the control group were not.Results Eighty--six patients with PLC were detected in the screening group, while 51 patients with PLCoccurred in the control group. In patients from the screening group 60.5% were in the early stage, 45.3%of them were with small liver cancer. However, in the control group the figures were 0 and 0respectively. In the screening group, 57 patients with PLC were detected by follow--up screening every 6months, 77.2% patients of this series were in the early stabs. However in the screening group the other29 patients with PLC were detected by screening but they were not followed up every 6 months. Earlystagr patientS were only 27.6% in this series. Conclusion This snarests mass screening, espeially continualscreening every 6 months in fixed population can diagnoze PLC early.