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KMID : 0376219920290010061
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Chonnam Medical Journal
1992 Volume.29 No. 1 p.61 ~ p.70
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Correlation between clinical manifestations and ultrasonographic findings of primary hepatocellular carcinoma
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Shin Dong-Hyeon
Jung Yong-Whan
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Abstract
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Background : Primary hepatocellular carcinoma is one of the most malignant cancers in terms of prognosis and frequency in Korea, and its clinical manifestations also vary greatly with individual cases. To correlate the clinical types with ultrasonographic findings of primary hepatocellular carcinoma and determinate a better diagnosis of primary hepatocellular carcinoma, we studied 87 cases of primary hepatocellular carcinoma at Chonnam National University Hospital from January 1987 to June 1991. The clinical types of primary hepatocellular carcinoma (frank, cirrhotic, occult, acute, acute abdominal, cholestatic) based on Berman’s classification compared to ultrasonographic findings of primary hepatocellular carcinoma based on Eggel’s gross anatomic classification.
Results: 1) The average age of the patients was 53.8±10.6 years and the ratio of male to female was 16.4 to 1. 2) The clinical types of primary hepatocellular carcinoma were 44 frank(50.6%), 18 cirrhotic (20.7%), 14 occult (16.1%), 5 febrile (5.7%), 4 acute abdominal (4.6%), 2 cholestatic (2.3%) types in order of frequecy. 3) The ultraonographic types of primary hepatocellular carcinoma were 38 nodular (43.7%), 35 massive (40.2%), 14 diffuse (16.1%) types in order of frequency. In Ultrasonographic findings, the febrile type was the largest in the tumor size(81.6±47.7 mm)(P<0.01). 4) In laboratory findings, the acute abdominal type was the highest (190.5±91.7U/L) and the occult type was the lowerest (60.4±32.5U/L) in the level of ALP(P<0.01). 5) The diffuse land massive types were more common in the frank type and the nodular type was more common in the crirrhotic and occult types. The clinical and ultrasonographic types of hepatocellular carcinoma were 18 frank-massive (20.7%), 15 frank-nodular (17.2%), 11 frank-diffuse (12.6%), 10 occult-nodular (11.5%), 9 cirrhotic-nodular (10.3%) types in order of frequency. 6) The occult-nodular type was the highest type in overall survival rate by Kaplan-Meier method.
Conclusion: These results suggested that correlation between clinical manifestations and ultrasonographic findings of primary hepatocellular carcinoma were not statistically significant due to a few cases. Early detection of the occult-nodular type as the highest type in overall survival rate of hepatocellular carcinoma may be related to prognosis of primary hepatocellular carcinoma.
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