AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopi...AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using 99mTechnetium pertechnetate. The shunt index was calculated from the ratio of 99mTechnetium pertechnetate in the heart and the liver. Data were analyzed using Student’s t-test and receiver operating characteristics.RESULTS: Cirrhotic patients showed a higher shunt index than normal subjects (63.80 ± 25.21 vs 13.54 ± 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 ± 9.40 vs 49.35 ± 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.CONCLUSION: In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.展开更多
Hepatocellular carcinoma (HCC) is the most common type of liver cancer worldwide.The incidence of HCC is on the rise in Thailand,where it has become the most common malignancy in males and the third most common in fem...Hepatocellular carcinoma (HCC) is the most common type of liver cancer worldwide.The incidence of HCC is on the rise in Thailand,where it has become the most common malignancy in males and the third most common in females.Here,we review some of the risk factors that have contributed to this increase in HCC incidence in the Thai population.Hepatitis B virus (HBV) is the main etiologic risk factor for HCC,followed by hepatitis C virus (HCV).Patients with HBV genotype C have a higher positive rate of hepatitis B early antigen (HBeAg) and progress to cirrhosis and HCC earlier than genotype B.For HCV patients,16% developed HCC associated cirrhosis by year 5 after diagnosis,and the cumulative risk for death from HCC at year 10 was 60%.Dietary exposure to the fungal hepatocarcinogen aflatoxin B1 has been shown to interact synergistically with HBV infection to increase the risk of early onset HCC.Chronic alcohol abuse remains an important risk factor for malignant transformation of hepatocytes,frequently in association with alcohol-induced cirrhosis.In recent years,obesity and metabolic syndrome have markedly increased the incidence of HCC and are important causes of HCC in some resource-rich regions.展开更多
基金Supported by the Gastroenterological Association of Thailand
文摘AIM: To investigate potential roles of per rectal portal scintigraphy in diagnosis of esophageal varices and predicting the risk of bleeding.METHODS: Fifteen normal subjects and fifty cirrhotic patients with endoscopically confirmed esophageal varices were included. Patients were categorized into bleeder and non-bleeder groups according to history of variceal bleeding. All had completed per rectal portal scintigraphy using 99mTechnetium pertechnetate. The shunt index was calculated from the ratio of 99mTechnetium pertechnetate in the heart and the liver. Data were analyzed using Student’s t-test and receiver operating characteristics.RESULTS: Cirrhotic patients showed a higher shunt index than normal subjects (63.80 ± 25.21 vs 13.54 ± 6.46, P < 0.01). Patients with variceal bleeding showed a higher shunt index than those without bleeding (78.45 ± 9.40 vs 49.35 ± 27.72, P < 0.01). A shunt index of over 20% indicated the presence of varices and that of over 60% indicated the risk of variceal bleeding.CONCLUSION: In cirrhotic patients, per rectal portal scintigraphy is a clinically useful test for identifying esophageal varices and risk of variceal bleeding.
文摘Hepatocellular carcinoma (HCC) is the most common type of liver cancer worldwide.The incidence of HCC is on the rise in Thailand,where it has become the most common malignancy in males and the third most common in females.Here,we review some of the risk factors that have contributed to this increase in HCC incidence in the Thai population.Hepatitis B virus (HBV) is the main etiologic risk factor for HCC,followed by hepatitis C virus (HCV).Patients with HBV genotype C have a higher positive rate of hepatitis B early antigen (HBeAg) and progress to cirrhosis and HCC earlier than genotype B.For HCV patients,16% developed HCC associated cirrhosis by year 5 after diagnosis,and the cumulative risk for death from HCC at year 10 was 60%.Dietary exposure to the fungal hepatocarcinogen aflatoxin B1 has been shown to interact synergistically with HBV infection to increase the risk of early onset HCC.Chronic alcohol abuse remains an important risk factor for malignant transformation of hepatocytes,frequently in association with alcohol-induced cirrhosis.In recent years,obesity and metabolic syndrome have markedly increased the incidence of HCC and are important causes of HCC in some resource-rich regions.
