Sonographic Screening for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Virus Infection
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Abstract
Background: Hepatocellular carcinoma (HCC) is the most common cancer in Thai men and the third most common cancer in Thai women. The important risk factor in Thailand is chronic hepatitis B virus infection.
Objective: To determine hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus infection and to calculates the sensitivity and positive predictive value of sonographic screening for hepatocellular carcinoma.
Methods: A prospective study was performed 1,085 sonograms of patients with chronic hepatitis B virus infection by radiologist that obtained over six months period. Five hundred thirty nine men and 546 women with a mean age of 40-49 years were included. Patients with positive sonographic finding and AFP level > 20 ng/ml were further investigated CT scan and MRI liver for evaluated characteristic of mass or nodule. The sensitivity and positive predictive value of sonographic screening and elevation of AFP > 20 ng/ml were calculated.
Results: Twenty three patients (2.13%) had liver mass or nodule on sonographic screening. Elevation of AFP > 20 ng/ml found in 17 patients (1.56%). Seven patients (0.65%) had hepatocellular carcinoma on CT scan and MRI liver studies. One patient (0.09%) had hepatocellular carcinoma with liver cirrhosis. Six patients (0.55%) had hepatocellular carcinoma with positive sonographic screening and 2 patients (0.18) had hepatocellular carcinoma with elevation of AFP > 20 ng/ml. The sensitivity and positive predictive value of sonographic screening and elevation of AFP >20 ng/ml were 85.7%, 26.1%, 28.6% and 11.8% respectively.
Conclusion: Hepatocellular carcinoma in chronic hepatitis B virus infection was 0.65%. Sonographic screening is superior to AFP assay for detection of hepatocellular carcinoma.
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References
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