A STUDY DSAGNOSIS OF PRIMARY LIVER CARCINOMA WITH NAGATIVE AFP / 第二军医大学学报

ABSTRACT

442 cases of primary liver carcinoma were admitted to our hospital from August 1975 to June 1983, and confirmed by surgery and pathologic examination. Of these 442 cases, 71 cases (16.8%) were AFP-negative (h magglutination titer 1:10, counter immuno-electrophoresis negative and radio-immuno-assay less than 31ng/ml). The ege of the patients ranged from 15 to 76 years old(average : 46), and the sex ratio between males and females was 4.9 = 1.The pathologic findings were 59 liver cell carcinomas, 10 bile duct cell carcinomas, 2 mixed types and 34(57.6%)pertaining to grade I or I-II, 22(37.3%) grade II-III or III and 3(5.1 %)grade III-IV in differentiation. 31 cases (43.6%) were found to have been combined witn cirrhosis.The most common clinical symptom was hepatodynia and other symptoms were anorexia, s:nse of abdomen distention,fever etc. 10 of the cases were misdiagnosed as caver- nous hemangicma of the liver, diseases of bile ducts and hydatid cyst of the liver before operation.Earlier diagnosis could be made by combining enzyme tcsts(PHI, LDH, rGT, AKP, A1AT etc),B-mode ultrasonography, angiograpby of hepatic artery, liver scanning and clinical symptons together.In addition, an evaluation of enzyme tests, B-mode ultrasonography,liver scanning and angiography of hepatic artery were also discussed as well as the differential diagnosis.