No abstract available.
Carcinoma, Hepatocellular* ; Diagnosis*

To determine the therapeutic plan and to predict the prognosis, it is a pivotal and important task to differentiate the exact nature of the various undifferentiated neoplasms. In order to solve this problem, the electron microscopy has once been considered only method in certain cases. Recently, however, the immunoperoxidase staining method which is less expensive and easier to usethan electron microscopy has been developed and introduced. To evaluate the diagnostic value of epithelial membrane antigen(EMA), carcinoembryonic antigen(CEA) and leukocyte common antigen(LCA) immunoperoxidase method, the authors applied these staining in 15 cases of which exact diagnoses were difficult with conventional routine and special stains, using the formalin-fixed and paraffin-embedded tissue sections. The results are as follows: 1) EMA was helpful in confirming the diagnosis or revising to the proper diagnosis of undifferentiated carcinoma in 4 of 6 cases and in excluding the possibility of hepatocellular carcinoma and melanoma in 2 cases, respectively. The negative stainabilities in one case of choriocarcinoma and one case of malignant fibrous histiocytoma was useful to exclude the possibility of squamous cell carcinoma and the positive stainability in one case of giant cell carcinoma to exclude the possibility of sarcoma. 2) The diagnostic value of CEA was similar to that of EMA; CEA was useful to differentiate from malignant lymphoma in one case of epithelial tumor in which CEA was positive and EMA negative. 3) LCA was useful to differentiate one case of malignant lymphoma from undifferentiated carcinoma and to confirm Ewing's sarcoma from malignant lymphoma in one case.
Diagnosis, Differential ; Carcinoma, Hepatocellular

In this study, fine needle aspiration cytopuncture (FNAC) was done for 220 patients with liver tumors. The findings showed that FNAC was of high value in diagnosis of Hepatocellular Carcinoma (HCC). Successful first time of FNAC was 93.2%. The accurate rate 97.7%, sensitivity 97.3% and specificity 100%. 19.6% patients were in well differentiated; 47.7% average differentiated and 32.7% poor differentiated. 86.7% tumor under 3cm in diameter with well-differentiation and 86.7% tumor over 9cm in diameter with poor-differentiated. The FNAC is simple, easy performing and safe method
Carcinoma, Hepatocellular, Diagnosis

A study was carried out on 40 hepatocellular carcinoma patients who were divided into 2 groups: 1st group (n=27) with AFP-L3<15% after treated by transcatheter oil chemoembolization (TOCE); 2nd group (n=13) with AFP-L3>15%. Results: the mean value of AFP-L3 in the 110 HCC patients was 54.623.7%, significantly higher (p<0.001) than the value in CLD (11.23.1%). When cut-off level was set 15% for AFP-L3, the sensitivity was 96.4%, and the specificity was 95%. The survival rates after 12 and 18 months of TOCE were 88.9% and 63% in the 1st group with AFP-L3<15% and 38.5% and 15.3% in the 2nd group with AFP-L3>15%, respectively. The recurrence of HCC for 1st and 2nd group were 10.23.5 months and 12.01.7 months, respectively
Carcinoma, Hepatocellular ; Therapeutics ; Diagnosis ; alpha-Fetoproteins

PURPOSE: To determine the enhancing patterns of hepatocellular carcinoma(HCC) and the difference of enhancing patterns according to the tumor size, using spiral CT. MATERIALS & METHODS: We reviewed 213 lesions in 76patients who had been clinically or histopathologically diagnosed as HCC sufferer. The tumors were divided into three groups, according to size(&3 cm, 3-5cm and >5 cm). The enhancing patterns of tumor and capsule in the earlyand delayed phase were analysed. The enhancing patterns of the tumor were divided into five types(high, peripheralhigh, mixed, iso and low attenuation) in the early phase and four types(central high, mixed, iso, and low attenuation) in the delayed phase. The enhancing patterns of the capsule were divided into three types such asiso, low and high attenuation. RESULTS: High attenuating lesions in the early phase were as follows : below 3cm 72% ; 3-5cm., 60% ; above 5cm., 49%. Mixed attenuating lesions in the early phase were as follows : below 3cm., 1%; 3-5cm., 22% ; above 5cm., 36%. Thus, most HCCs were high attenuation type in the early phase, but as the tumorbecame larger, less high attenuation and more mixed attenuation was demonstrated(p<0.01). There was no difference of enhancing patterns according to the tumor size in peripheral high, iso and low-attenuating lesions. In the delayed phase most of the hepatomas appeared as totally hypodense lesions. For capsules, the results were as follows : below 3cm., 20% ; 3-5cm.,58% ; above 5cm., 73%. As the tumors became larger, more capsules were demonstrated(p <0.01). The capsules were visualized as iso or low attenuating rim in the early phase and high attenuating rim in the delayed phase. CONCLUSIONS: To determine the enhancing patterns of HCC using spiral CT is considered to be helpful in the diagnosis of HCC.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Tomography, Spiral Computed*

The prognostic role of aberrant serum miRNA expression for predicting response to sorafenib treatment in advanced hepatocellular carcinoma (HCC) patients has not been well characterized. We aimed to identify specific serum miRNAs that are associated with positive radiologic responses or improved survival in sorafenib-treated HCC patients. miR-18a, miR-21, miR-139-5p, miR-221, miR-224, and miR-10b-3p, were selected for analysis. Serum samples from 24 patients with advanced stage HCC and 25 patients with liver cirrhosis (LC) were analyzed. All of the miRNAs except miR-21 were found to be upregulated in serum samples from HCC patients. None of the miRNAs assayed differed significantly in terms of expression between the responder and non-responder groups among HCC patients. However, miR-10b-3p levels were significantly higher in the subgroup of HCC patients with worse overall survival (fold change = 5.8, P = 0.008). Serum miRNA-10b-3p was upregulated in the presence of macrovascular invasion (MVI), and those with higher serum miRNA-10b-3p had significantly shorter survival during treatment (P = 0.042). Although no single serum miRNA was predictive of response to sorafenib treatment, analysis of serum miR-10b-3p levels may be valuable for diagnosis of HCC and prediction of survival of sorafenib-treated patients.
Carcinoma, Hepatocellular* ; Diagnosis ; Humans ; Liver Cirrhosis ; MicroRNAs

Examination the usefulness of the lectin reactive alpha-fetoprotein (AFP-L3) in patients with hepatocellular carcinoma (HCC), chronic liver disease (CLD) and patients with HCC treated by transcatheter oil chemoembolization (TOCE). AFP-L3 levels were measured by lectins affinity electrophoresis and antibody affinity blotting. After TOCE, 40 HCC patients were divided in two groups: 1st group (n=27) with AFP-L3 < 15%; 2nd group (n=13) with AFP-L3 > 15%. Results: The mean value of AFP-L3 in the 110 HCC patients was 54.6  23.7%, significantly higher (p<0.001) than the value in CLD (11.2  3.1%). When the cut-off level was set 15% for AFP-L3, the sensitivity was 96.4%, the specificity was 95%. Survival rates after 12 and 18 months for all 27 patients calculated according to the Kaplan-Meier methods were 88.9% and 63% in the 1st group and 38.5% and 15.3% in the 2nd group, respectively. The recurrence of HCC for 1st and 2nd group were 10.2  3.5 months and 12.0  1.7 months, respectively.
Carcinoma, Hepatocellular ; Diagnosis ; Lectins ; alpha-Fetoproteins

Hepatoma is one of the most common malignant disease among cancers that occur in Korea. Recently, according ta developing imaging diagnostic technology and non surgical treatment the hepatoma is easily detected in early diagnosis and appropriate treatment. From this point of view, the histologic pattern of hepatoma is markedly important. This is the first reported case of sclerosing hepatocellular carcinoma, which is characterized by intense fibrosis, in which the tubular neoplastic structures are embedded. The incidence of sclerosing hepatocellular carcinoma is very rare. Therefore the rare histologic pattern of hepatoma might be introduced by many studies and reports. We recently experienced a case of sclerosing hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Early Diagnosis ; Fibrosis ; Incidence ; Korea

Alpha-fetoprotein (AFP) is frequently used for hepatocellular carcinoma (HCC) diagnosis and surveillance. Although the current ARCHITECT AFP (List number 7K67) assay range is 0–350 ng/mL, all samples with test results between 200 and 350 ng/mL must be diluted and retested until their levels are <200 ng/mL. A new ARCHITECT AFP (8100/3P36) assay with a dynamic range of up to 2000 ng/mL has been introduced. The aim of this study was to perform a method comparison between the current ARCHITECT AFP assay and the new assay. The precision study showed excellent results for both high and low controls. There was a positive correlation between the two assay systems and clinical samples. The new ARCHITECT AFP assay with a wide assay range demonstrated good analytical performance. Therefore, the current ARCHITECT AFP assay could be replaced by the new assay, which is more convenient and minimizes manual labor.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Diagnosis ; Methods

Contrast-enhanced ultrasonography (CEUS) using microbubble ultrasonography contrast agent can show the vascular structure and unique contrast enhancement patterns of focal liver lesions, including hepatocellular carcinoma (HCC). CEUS shows three phases, similar to a vascular pattern on computer tomography (CT), and typical arterial enhancement and portal or late phase washout in HCC. CEUS can show real-time images without nephrotoxicity or radiation hazard and can be used as guidance for loco-regional treatment and estimation of treatment response of HCC. In addition, some data recently revealed the usefulness of CEUS in the early estimation of response to anti-cancer pharmacological (i.e., sorafenib) therapy in advanced HCC. Although CEUS has limitations in clinical practice and more investigation is needed for its validation, it is recommended as a main diagnostic modality in a few major clinical practice guidelines for HCC. Thus, greater understanding of CEUS is necessary to extend its application in real practice for diagnosis and management of diseases.
Carcinoma, Hepatocellular ; Diagnosis ; Liver ; Microbubbles ; Ultrasonography