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        간경변증 환자에서 간세포암 발생 위험 요인의 분석

        이헌주(Heon Ju Lee),이재련(Jae Lyun Lee),이재춘(Jae Chun Lee),이은정(Eun Jung Lee),김기범(Ki Beom Kim),임상우(Sang Woo Lim),이동준(Dong Jun Lee),전경진(Kyeoung Jin Jeon),조영복(Young Bog Cho),도갑석(Gab Suk Doh),서정일(Jeong Ill Suh) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

        N/A Objectives: 80-90% of the cases of hepatocellular carcinoma(HCC) are associated with cirrhosis. Hepatitis B virus(HBV) is known as a major etiologic factor of HCC and about 10% of Koreans are HBV carriers. And the prevalence of HCC is high in Korea. Early detection of HCC is important for the better treatment especially in the patients with cirrhosis who usually have the decreased functional hepatic reserve. Risk factors for the hepatocellular carcinoma in the korean patients with cirrhosis were evaluated. Methods: Risk factors for hepatocellular carcinogenisis such as age, sex, ascites, alcohol, HBsAg, anti-HCV, AFP, ICG R(15) and risk score were investigated among the 176 patients with cirrhosis and HCC(group I) and 72 patients with cirrhosis(group II) and compared between the two groups. Results: 1) No age difference was noted between group I and group II. 2) Male to female sex ratio were 5.7: 1 and 2.4: 1 for group I and II in each(p<0.01) and the frequency of HCC among cirrhosis was higher in male than female sex(p<0.01). 3) Both HBsAg and anti-HCV positivity were significantly higher in group I than in group II (p<0.01 and p<0.05 respectively). 4) The frequencies of Child-Pugh A, elevated AFP, elevated ICG R(15) and the frequency of super-high risk patient were higher in group I than in group II(p<0.01). 5) The frequency of alcoholic patients was significantly higher in group II than in group I (p<0.05) but no difference was noted between HBsAg positive group I and group II patients. 6) The frequency of abnormal AST with the level of below 100IU was not significantly different between group I and group II. 7) The frequency of the patients with ascites was higher in group II than in group I (p<0.01). Conclusion: Risk factors for hepatocellular carcinogenesis in korean patients with cirrhosis are male, Child-Pugh A, HBsAg positivity, anti-HCV positivity, absence of ascites, higher AFP, lower ICG R15 and higher platelet count.

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