The incidence of primary liver cancer, hepatoma, is high in Korea together with acute And chronic type of liver diseases. We detected AFP in the serum of 389 Korean patients with hepatoma, HBsAg in 331 and anti-HBs in 250. AFP was tested by micro-Ouchterlony double diffusion method, HBsAg by modified micro-Ouchterlony double diffusion test by which the sensitivity was increased about 8 times original method, and anti-HBs by PHA in which over 1 : 16 PHA titer was thought to be anti-HBs positive.
AFP was found positive in 67.87% of the patients with hepatoma (264/384), and positive in same ratio in both sexes. The positivity of AFP was most frequent in the patients under the age of 30, 92.86%, and decreased with the increment of age showing 44.44% positive rate of AFP in the patients above the age of 70. It was observed that AFP is apt to be positive in the patients positive for HBsAg and in patients whose histopathologic findings showed concomitant findings of chronic active liver disease.
Accurate diagnosis for hepatoma can be made by the liver needle biopsy alone in 74.12% (63/85), but be raised up to 87.06%(63+11/85) when liver needle biopsy for the diagnosis was performed together with the double diffusion assay for AFP as a screening test. No AFP was found to be positive in five cases of cholangiocarcinoma. seen.
Serum HBsAg was found to be positive in 34. 44% of the patients with hepatoma (114/331), and anti-HBs in 28.80% of the cases tested(72/250). The occurrence of HBsAg was a little bit higher in male patients than in female, and there was no correlation between age prevalence and the occurrence of HBsAg and anti-HBs. It was, however, observed that the occurrence of HBsAg and anti-HBs was higher among the cases whose histologic findings showed the concomitant evidence of chronic active liver diseases than in cases without the evidence. It is suggested, then, by our results together with the findings of high occurrence of HBsAg among Korean patients with chronic active liver diseases that the chronic infection with hepatitis B virus plays a role for the pathogenesis of hepatoma in Korea.
(This work was supported in part by the grant No. 73-300-12 from China Medical Board of New York, Inc.)
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