Abstract
One hundred and forty-four cases of hepatoma were observed during the past 8 years and the way of reaching the diagnosis in these cases were analyzed. The 8 years' period of investigation was divided into 2 parts, the early and the late period, namely, before and after the advent of linear electric ultrasonic scanner.
In the early period (71 cases), the main diagnostic methods for hepatoma were mainly alpha-fetoprotein (AFP) and isotope scanning (RI), so the early detection of hepatoma was very difficult. But, in the late period (73 cases), important diagnostic tests including ultrasonic scanning (US), computed tomography (CT) and celiac angiography (Angio. ) were easily available, so the detectability of hepatoma was markedly improved.
The most useful test for the screening of hepatoma was US because of its simplicity and good sensitivity, the most sensitive method was lipiodol-CT that was CT examination after an intra-arterial injetion of lipiodol since the lipiodol was selectively accumulated in the nodule of hepatoma, and the most reliable pathological examination before the treatment was US guided aspiration cytology. In other methods, AFP was a useful tumor marker if it showed an abnormal level, but it should be remembered that AFP was within normal level in about 20% of hepatoma patients. RI was less useful for hepatoma, espe-cially in its early stage because of its unfavorable sensitvity.
Using these diagnostic methods, 24 cases with small hepatoma (5-3cm: 13 cases, 3cm>: 11 cases) were detected in the late period, but the fact that 33% of these cases were detected as multinodules should be born in mind for the therapy.
Now, the diagnostic methods for hepatoma was established in our hospital, and the patients with chronic liver disease and HBsAg carrier were at high risk for hepatoma
