Significance of the AFP Level and HBsAg in Differentiation of Hepatic Masses

간종괴의 감별진단에 있어서 AFP수치와 HBsAg의 의의

Hepatic masses show different enhancing patterns in IV bolus computed tomography: Hepatocellular carcinoma shows high-attenuation in the early enhancing phase and low-attenuation in the late enhancing phase, hemangioma shows peripheral dot-like high-attenuation in the early enhancing phase and central high-attenuation in the late enhancing phase, and metastatic cancer and cholangiocelluar carcinoma show peripheral high-attenuation rim in the early enhancing phase and central portion gradulally high-attenuation in the late enhancing phase. but sometimes enhancing patterns of the hepatic masses are confuse. To evaluate the significance of the AFP level and HBsAg in differentiation of the hepatic masses, we retrospectively analyzed AFP level and HBsAg in 228 pathologically or radiologically confirmed hepatocellular carcinomas, and 137 pathologically nonhepatocellular cacinomas. The results were as follows : In hepatocellular carcinoma, AFP level above 20ng/ml was 77.8% and HBsAg positve was 72.6%. In nonhepatocellular carcinoma, AFP level above 20ng/ml was 3.7% and HBsAg positve was 16.1%. We concluded that AFP level and HBsAg are helpful to distinguish hepatocellular carcinoma from nonhepatocellular carcinoma, when IV bolus computed tomogram finding is uncertain.

급속조영 전산화단층촬영에서 다른 간종괴와 감별이 어려운 간세포암의 경우 AFP 수치의 상승과 HBsAg 양성은 간세포암을 시사하는 유용한 지표이며 종괴의 모양과 조영양상을 같이 고려한다면 간종괴의 감별진단에 많은 도움을 주리라 생각한다.