Tumor markers are more useful in patients undergoing surveillance for hepatocellular carcinoma with unreliable results by ultrasonography. Issue 4 (19th June 2014)

• Record Type: Journal Article
• Authors: Mikami, Shintaro; Tateishi, Ryosuke; Hagiwara, Shu; Sato, Masaya; Minami, Tatsuya; Uchino, Koji; Enooku, Kenichiro; Sato, Takahisa; Nakagawa, Hayato; Masuzaki, Ryota; Asaoka, Yoshinari; Kondo, Yuji; Shiina, Shuichiro; Ikeda, Hitoshi; Omata, Masao; Yoshida, Haruhiko; Koike, Kazuhiko
• Is Part Of: Hepatology research. Volume 45:Issue 4(2015:Apr.)
• Page Start: 415
• Page End: 422
• Publication Date: 2014-06-19
• Subjects: Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.12365
• Languages: English
• ISSNs: 1386-6346

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hepr12365-sec-0001" sec-type="section"> <title>Aim</title> <p>The objectives of this study was to evaluate the utility of tumor markers in hepatocellular carcinoma (HCC) surveillance based on the reliability of ultrasonography.</p> </sec> <sec id="hepr12365-sec-0002" sec-type="section"> <title>Methods</title> <p>We analyzed 313 patients with HCC detected through a surveillance program using ultrasonography combined with three tumor markers from February 2000 to December 2010. The patients were categorized into two groups based on the triggering event: the US group (<italic>n</italic> = 281) in which a tumor was first detected using ultrasonography and the TM group (<italic>n</italic> = 32) in which elevated tumor markers led to the diagnosis of a tumor that was undetected using ultrasonography. The reliability of ultrasonography was scored on a 4‐point scale based on three items (coarseness of liver parenchyma, patient obesity and liver atrophy). Additionally, patient survival was assessed using the Kaplan–Meier method and log–rank test.</p> </sec> <sec id="hepr12365-sec-0003" sec-type="section"> <title>Results</title> <p>The median tumor size was 20 mm (interquartile range, 15–24). The reliability of ultrasonography was evaluated as good in 208 (66.5%), satisfactory in 80 (8.0%), poor in 21 (6.7%) and unsatisfactory in four (1.2%) patients. The proportion of patients in the TM group increased significantly according to the score, from 7.2% to 25.0% (<italic>P</italic> = 0.01). The survival rates of patients at 3 and 5 years were 83.7% and 57.2% in the US group, and 79.3% and 59.4% in the TM group, respectively (<italic>P</italic> = 0.98).</p> </sec> <sec id="hepr12365-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Tumor markers may play a diagnostic role in patients with unreliable ultrasonography results. The survival of patients diagnosed by elevated tumor markers was not significantly different from those diagnosed by ultrasonography.</p> </sec> </abstract>