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首页> 外文期刊>Digestive Diseases and Sciences >Primary hepatocellular carcinoma detected long after tumor markers and lymph node metastases--beyond our vision?
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Primary hepatocellular carcinoma detected long after tumor markers and lymph node metastases--beyond our vision?

机译：在肿瘤标志物和淋巴结转移后不久就发现了原发性肝细胞癌，这超出了我们的视野吗？

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摘要

Hepatocellular carcinoma (HCC) is one of the most common cancers associated with poor prognosis in eastern Asia, including Japan, Taiwan, Korea, and China (1). Several imaging modalities and serologic tumor markers have been widely used for early diagnosis and therapeutic follow-up in the past decades. Mutual screening works efficiently at present among high-risk patients with chronic viral hepatitis, cirrhosis, or a family history of HCC. However, HCC behaves in many diverse ways, which makes early diagnosis difficult and delays immediate therapeutic strategies for a better clinical outcome. On some rare occasions, discrepancy may exist among the time at which diagnosis is made based on the results of tumor markers, imaging modalities, and clinical presentation. This discrepancy could be readily overcome by meticulous surveillance within a limited period of time because of the rapid growth nature of HCC.We encountered an asymptomatic HCC patient who presented with progressively increased abnormal AFP and des-gamma-carboxyprothrombin (PIVKA-II) levels. Although all the advanced imaging modalities were thoroughly and repeatedly performed, the identification of primary HCC was far preceded not only by the initial elevation of the AFP level but also by the lymph node metastases (LM).
机译：肝细胞癌（HCC）是与包括日本，台湾，韩国和中国在内的东亚地区预后不良相关的最常见癌症之一（1）。在过去的几十年中，几种成像方式和血清学肿瘤标志物已被广泛用于早期诊断和治疗随访。目前，在患有慢性病毒性肝炎，肝硬化或HCC家族史的高危患者中，相互筛查有效。然而，HCC表现为多种多样的方式，这使得早期诊断变得困难，并延迟了立即的治疗策略，以取得更好的临床效果。在极少数情况下，根据肿瘤标志物，成像方式和临床表现的结果进行诊断的时间可能存在差异。由于HCC的快速生长特性，可以通过在有限的时间内进行细致的监测来克服这种差异。尽管所有先进的影像学检查方法都可以重复进行，但原发性肝癌的诊断不仅要先提高AFP水平，还要先行淋巴结转移（LM）。

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