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肝癌的诊断和治疗的最新概况6
釔九十微粒內放射治療 治療特大而又未擴散的肝癌 有良好的肝功能 通過血管鏡和核子掃描測試 經肝動脈注射一次過的治療 Early Detection of HCC - HKU study Comparing 142 HCC detected by screening and 164 patients with symptomatic disease Benefit: Smaller tumor detected Higher chance of treatment with surgery or chemoembolization Better survival for those in screening programme Hepatitis B as a Risk Factor The relative risk of HCC in the HBV carriers was about 100 compared with non-carrier The yearly incidence of HCC in the HBsAg positive group was 0.5%, increasing to 1% at the age of 70 In cirrhotic HBV carriers, the relative risk was 960 The incidence of HCC in cirrhotics was 2.5% per year Hepatitis C as a Risk Factor In hepatitis C induced cirrhosis, the incidence of HCC is between 2% to 8% per year The incidence of HCC is between 20 and 200 times more common in hepatitis C cirrhosis than in the non-infected group The Screening Tests Used Serum AFP USG of the liver AFP as Surveillance Test Sensitivity of 39-64% Specificity of 76-91% Positive predictive value of 9-32% AFP Tumour marker for AFP Also raised in normal pregnancy, chronic hepatitis, cirrhosis and germ cell tumours AFP at low levels (between 50ng/ml and 500ng/ml) decreases specificity for HCC Investigation of an elevated AFP 承 蒙 梁惠棠教授 香港養和醫院名譽顧問醫生 香港大學醫學院名譽助理教授 借出講座資料 香港防癌會 特此鳴謝 亦請瀏覽本會網頁 「香港常見之癌症」之「肝癌」 * (Yuen MF et al, Hepatology 31(2):330-5, 2000) Sherman M (1995), Oka H (1994), Paterson D (1994) AFP 20ng/ml 20ng/ml Repeat in 3 – 6 months USG positive negative CT scan +/- other Ix AFP rising trend * * *
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