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1971～1976年,上海市肝癌研究协作组用检测甲种胎儿蛋白(AFP)的方法对1,967,511自然人群进行了普查,查出300例原发性肝细胞癌~*(普查组),本文报告其中134例无肝癌症状体征的早期病人(早期组)。普查组与就诊组(1,200例)比,早期比例显著增高(自0.4%增至44.7%)。手术证明,早期组81.6%为≤5厘米的小肝癌。除 AFP 外,各项检查的阳性率仅为就诊组的1/4。切除占全组的比例为就诊组的3倍(23.1%和8%)。治后一年、二年、三年生存率分别为73.4%、38.5%和18.9%。各种治疗方法中以手术切除的远期疗效最好,其一年、二年、三年生存率达86.7%、75.0%和57.1%。以上资料说明,AFP 普查对原发性肝癌具有早期诊断和提高远期疗效(尤其是手术切除)的价值。本文就早期肝癌诊断和治疗上的一些新问题进行讨论。
From 1971 to 1976, Shanghai Liver Cancer Research Collaborating Group conducted a survey of 1,967,511 natural populations using AFP method to detect 300 cases of primary hepatocellular carcinoma (Census group). 134 cases of early patients without signs and symptoms of liver cancer (early group). Compared with the census group (1,200 cases), the early proportion was significantly higher (from 0.4% to 44.7%). Surgery proved that 81.6% of the early group were small HCCs ≤ 5 cm. With the exception of AFP, the positive rate of all tests was only 1/4 of that of the visiting group. The proportion of excision in the whole group was 3 times (23.1% and 8%) in the treatment group. The one-, two-, and three-year survival rates after treatment were 73.4%, 38.5%, and 18.9%, respectively. Among the various treatment methods, the long-term curative effect of surgical resection was best. The one-, two-, and three-year survival rates were 86.7%, 75.0%, and 57.1%. The above information shows that the AFP census has the value of early diagnosis and improvement of long-term efficacy (especially surgical resection) of primary liver cancer. This article discusses some new issues in the diagnosis and treatment of early liver cancer.