간세포암의 근치적 절제술후 재발 진단 방법의 유용성

다국어 초록 (Multilingual Abstract)

Background/Aims : In spite of improved diagnostic and therapeutic methods, the prognosis of hepatocarcinoma(
HCC) is still poor because of the high recurrence rate. Early detection and active treatment
of recurrent HCC are important to improve the survival. The objective of this study is to compare the
effectiveness of diagnostic tools for early detection of the recurrence of HCC.
Methods : We retrospectively studied 236 patients who underwent curative hepatic resection for HCC
at SNUH between 1993 and 1995. Postoperatively, we checked radiologic studies every three months
and serum α- fetoprotein level monthly first, then every three months to detect recurrence. The
patients were divided into four group (Low-Low;L-L, Low-High;L-H, High-Low;H-L, High-High;H-H)
according to the serum levels of pre- and post-operative(3 months) α-fetoprotein levels (Low ;
<20ng/ml, High >20ng/ml).
Results : Overall recurrence rate was 55.1%. The recurrence rates in L-L gr., L-H gr, H-L gr., and H-H
gr were 40.7%, 75.0%, 42.9% and 91.8% respectively. Increasing levels of α-fetoprotein at the time of
dectection of recurrence were found in 13.6%, 66.7%, 25.9% and 92.9%, respectively(p<0.05). The 3-
year disease-free survival rates are 62.1%, 25.0%, 57.8% and 6.3%, respectively(p<0.05). The 3-year
overall survival rates are 79.2%, 50.0%, 83.6% and 51.1%, respectively(p<0.05). The detection rates of
ultrasonography(US) and computed tomograpy(CT) were 82.4% and 97.2% respectively. Seven patients
had lung metastasis on chest X-ray and two bone metastasis on bone scan, two spinal metastasis on
spine X-ray and MRI and 2 adrenal metastasis by US and CT were detected.
Conclusion : The patients who have high serum levels of α-fetoprotein postoperatively have a tendency
to recur early. On the other hand, patients who have low serum levels of α-fetoprotein postoperatively
recur late, usually without its elevation. Therefore, in former cases, early recurrence or remnant
tumor should be suspected and in latter cases, regular US and/or CT is a more useful method for early
detection of recurrent HCC than frequent checking of serum α-fetoprotein.

다국어 초록 (Multilingual Abstract)

Background/Aims : In spite of improved diagnostic and therapeutic methods, the prognosis of hepatocarcinoma(
HCC) is still poor because of the high recurrence rate. Early detection and active treatment
of recurrent HCC are important to improve the survival. The objective of this study is to compare the
effectiveness of diagnostic tools for early detection of the recurrence of HCC.
Methods : We retrospectively studied 236 patients who underwent curative hepatic resection for HCC
at SNUH between 1993 and 1995. Postoperatively, we checked radiologic studies every three months
and serum α- fetoprotein level monthly first, then every three months to detect recurrence. The
patients were divided into four group (Low-Low;L-L, Low-High;L-H, High-Low;H-L, High-High;H-H)
according to the serum levels of pre- and post-operative(3 months) α-fetoprotein levels (Low ;
<20ng/ml, High >20ng/ml).
Results : Overall recurrence rate was 55.1%. The recurrence rates in L-L gr., L-H gr, H-L gr., and H-H
gr were 40.7%, 75.0%, 42.9% and 91.8% respectively. Increasing levels of α-fetoprotein at the time of
dectection of recurrence were found in 13.6%, 66.7%, 25.9% and 92.9%, respectively(p<0.05). The 3-
year disease-free survival rates are 62.1%, 25.0%, 57.8% and 6.3%, respectively(p<0.05). The 3-year
overall survival rates are 79.2%, 50.0%, 83.6% and 51.1%, respectively(p<0.05). The detection rates of
ultrasonography(US) and computed tomograpy(CT) were 82.4% and 97.2% respectively. Seven patients
had lung metastasis on chest X-ray and two bone metastasis on bone scan, two spinal metastasis on
spine X-ray and MRI and 2 adrenal metastasis by US and CT were detected.
Conclusion : The patients who have high serum levels of α-fetoprotein postoperatively have a tendency
to recur early. On the other hand, patients who have low serum levels of α-fetoprotein postoperatively
recur late, usually without its elevation. Therefore, in former cases, early recurrence or remnant
tumor should be suspected and in latter cases, regular US and/or CT is a more useful method for early
detection of recurrent HCC than frequent checking of serum α-fetoprotein.