Sirotik Hastalarda Hepatoselüler Kanser Taramasında Tomografi

Authors : Arzu Tiftikçi, Ali Sever, Davut Tüney, Yeşim Karagöz, Nurdan Tözün, Osman Özdoğan

Pages : 195-198

View : 60 | Download : 17

Publication Date : 2011-12-01

Article Type : Research

Abstract :Aim: Hepatocellular carcinoma HCC is a significant cause of mortality in patients with chronic liver disease. The aim of this study was to analyze cost and the effectiveness of HCC screening in cirrhotic patients using abdominal computer tomography CT yearly in addition to ultrasonographic USG examination of the liver and serum alpha-feto protein AFP assay every 6 months. Patients and Methods: A total of 39 patients were followed-up for two years by screening with USG evaluation and AFP assay every 6 months and with contrast-enhanced abdominal CT yearly. Results: The patients comprised 22 men and 17 women mean age: 62 ± 10 years . Fifteen patients had hepatitis B virus, 9 had hepatitis C virus, 4 had both hepatitis B and C viruses, 3 had hepatitis B virus and ethanol abuse, 1 had hepatitis C and ethanol abuse and 7 had cryptogenic cirrhosis. The mean duration of cirrhosis was 3.4 ± 2.7 years. The diagnosis of liver cirrhosis was made on clinical, biochemical, USG and endoscopic findings. In a total of 39 patients, 5 of them had suspected hepatic lesion with a size of 1.2–5 cm upon examination with abdominal CT. Only one patient was diagnosed with cholangiocarcinoma but not with HCC with additional examination with CT arteriography and was underwent resection. No lesion was determined in other 4 patients examined additionally with abdominal MRI or abdominal CT arteriography. The cost of USG examination and serum AFP assay of one patient every 6 months was approximately 150 TL. The total yearly cost of USG + serum AFP of 39 patients was 11700 TL. The total yearly cost of abdominal CT of 39 patients was 9009 TL. Considering 5 patients with suspected lesions, the total cost of additional examinations was 1947 TL. Conclusion: Additional screening with CT did not improve the early detection of HCC but increased the yearly cost in cirrhotic patients.
Keywords : hepatocellular carcinoma, screening, computed tomography