False Positive Diagnosis of Hepatocellular Carcinoma in Liver Resection Patients.
10.3346/jkms.2017.32.2.315
- Author:
Hongeun LEE
1
;
Jeong Hee YOON
;
Hyeyoung KIM
;
Nam Joon YI
;
Suk Kyun HONG
;
Kyung Chul YOON
;
Hyo Sin KIM
;
Sung Woo AHN
;
Jin Young CHOI
;
YoungRok CHOI
;
Hae Won LEE
;
Ju Yeon YI
;
Kyoung Bun LEE
;
Kwang Woong LEE
;
Kyung Suk SUH
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. gsleenj@hanmail.net
- Publication Type:Original Article
- Keywords:
Hepatocellular Carcinoma;
False-positive Diagnosis;
Clinical Diagnosis;
Liver Resection
- MeSH:
Adenoma;
Adenoma, Bile Duct;
Alcoholism;
alpha-Fetoproteins;
Angiomyolipoma;
Carcinoma, Hepatocellular*;
Cohort Studies;
Cystadenocarcinoma;
Diagnosis*;
Diagnostic Imaging;
Hemangioma;
Hepatitis;
Hepatoblastoma;
Humans;
Inflammation;
Liver*;
Nasopharynx;
Prevalence;
Reference Values;
Retrospective Studies
- From:Journal of Korean Medical Science
2017;32(2):315-320
- CountryRepublic of Korea
- Language:English
-
Abstract:
The diagnosis of hepatocellular carcinoma (HCC) is based on imaging studies particularly in high-risk patients without histologic confirmation. This study evaluated the prevalence and characteristics of false-positively diagnosed HCC in a liver resection cohort for HCC. A retrospective review was performed of 837 liver resection cases for clinically diagnosed HCC between 2005 and 2010 at our institute. High-risk patients with tumors > 1 cm with one or two image findings consistent with HCC and tumors < 1 cm with two or more image findings consistent with HCC with persistently increased serum alpha-fetoprotein (AFP) levels above the normal range with underlying inhibited hepatitis activity underwent liver resection. The false-positive rate was 2.2% (n = 18). Of the 18 patients, 7 patients (0.8%) were diagnosed with benign conditions (one each of hemangioma, inflammation, cortical adenoma, dysplastic nodule, angiomyolipoma, bile duct adenoma, and non-neoplastic liver parenchyme) and 11 patients (1.3%) were diagnosed with malignancies (cholangiocarcinoma [n = 6], hepatoblastoma [n = 2], and one each of lymphoepithelioma-like carcinoma, ovarian cystadenocarcinoma, and nasopharynx carcinoma metastasis). The clinical characteristics of pathologically diagnosed HCC patients were similar (P > 0.05) compared to non-HCC patients except for higher rate of history of alcoholism (P < 0.05) observed in non-HCC patients. Four of 18 non-HCC patients (22.2%) showed diagnostic discordance on the dynamic imaging study. Despite the recent progression in diagnostic imaging techniques, 2.2% of cases were false-positively diagnosed as HCC in a liver resection patient cohort; and the final diagnosis was benign disease in 0.8% of liver resection patients clinically diagnosed with HCC.
