TY - JOUR
T1 - Community-based mass ultrasonographic screening of hepatocellular carcinoma among thrombocytopenic adults
AU - Lu, Sheng Nan
AU - Wang, Jing Houng
AU - Chen, Pao Fei
AU - Tung, Hung Da
AU - Tseng, Po Lin
AU - Hung, Chao Hung
AU - Kee, Kwong Ming
AU - Chen, Chien Hung
AU - Chang, Kuo Chin
AU - Lee, Chuan Mo
AU - Changchien, Chi Sin
AU - Chen, Yao Der
AU - Tsai, Lin San
AU - Chen, Tony Hsiu Hsi
PY - 2008/7
Y1 - 2008/7
N2 - Thrombocytopenia has been reported as a valid surrogate for liver cirrhosis and could be used to identify groups at high risk of hepatocellular carcinoma (HCC) for ultrasonographic (US) screening. We designed this two-stage community-based screening for HCC. In 2004, subjects (ages ≥40 years) were invited to undergo comprehensive health examinations, with 17,551 men (ages 63.0 ± 11.5 years) and 39,151 women (ages 59.9 ± 11.7 years) participating. Subjects with platelet counts <150 × 109/L or α-fetoprotein (AFP) >20 ng/mL were enrolled for the second-stage US screening; 3,242 subjects (5.7%; male/female, 1,415/1,827; age 66 ± 10 years) were candidates for US screening and 2,983 (92.2%) responded. Of 137 suspected cases, 124 (90.5%) complied with referral for confirmation and 72 (58.1%) were confirmed to be HCC cases (male/female, 41/31; age 68.1 ± 8.8 years). Screening with AFP, thrombocytopenia, or both could identify 0.64% (n = 364), 5.33% (n = 3,205), and 5.7% (n = 3,242) of the high-risk subjects from the population, estimated to include 50.5%, 54.5%, and 71.3% of all HCC cases. Among confirmed patients, tumor diameters were <3 cm for the 27 (37.5%) patients and 3 to 5 cm for the <3 (31.9%) patients. Only 5 (6.9%) patients' conditions were too advanced to be actively treated. This study enrolled only 5.7% of the participants for US, which cover 64.7% to 71.3% of the HCC cases. Most (93%) of the detected cases were caught early enough to undergo effective treatment modalities. This HCC screening protocol should be feasible, economical, and effective.
AB - Thrombocytopenia has been reported as a valid surrogate for liver cirrhosis and could be used to identify groups at high risk of hepatocellular carcinoma (HCC) for ultrasonographic (US) screening. We designed this two-stage community-based screening for HCC. In 2004, subjects (ages ≥40 years) were invited to undergo comprehensive health examinations, with 17,551 men (ages 63.0 ± 11.5 years) and 39,151 women (ages 59.9 ± 11.7 years) participating. Subjects with platelet counts <150 × 109/L or α-fetoprotein (AFP) >20 ng/mL were enrolled for the second-stage US screening; 3,242 subjects (5.7%; male/female, 1,415/1,827; age 66 ± 10 years) were candidates for US screening and 2,983 (92.2%) responded. Of 137 suspected cases, 124 (90.5%) complied with referral for confirmation and 72 (58.1%) were confirmed to be HCC cases (male/female, 41/31; age 68.1 ± 8.8 years). Screening with AFP, thrombocytopenia, or both could identify 0.64% (n = 364), 5.33% (n = 3,205), and 5.7% (n = 3,242) of the high-risk subjects from the population, estimated to include 50.5%, 54.5%, and 71.3% of all HCC cases. Among confirmed patients, tumor diameters were <3 cm for the 27 (37.5%) patients and 3 to 5 cm for the <3 (31.9%) patients. Only 5 (6.9%) patients' conditions were too advanced to be actively treated. This study enrolled only 5.7% of the participants for US, which cover 64.7% to 71.3% of the HCC cases. Most (93%) of the detected cases were caught early enough to undergo effective treatment modalities. This HCC screening protocol should be feasible, economical, and effective.
UR - http://www.scopus.com/inward/record.url?scp=53549132814&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-07-2746
DO - 10.1158/1055-9965.EPI-07-2746
M3 - 文章
C2 - 18628436
AN - SCOPUS:53549132814
SN - 1055-9965
VL - 17
SP - 1813
EP - 1821
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 7
ER -