2014 The Korean Liver Cancer Study Group and the National Cancer Center 간세포암종 개정 가이드라인: 1 cm 미만 간세포암종의 비침습적 진단기준이 너무 엄격한가?
Noninvasive Diagnostic Criteria of the Revised 2014 the Korean Liver Cancer Study Group and the National Cancer Center Guideline for Subcentimetersized Hepatocellular Carcinoma: Is It Too Strict?

Journal of Liver Cancer 2018년 18권 1호 p.44 ~ p.50

김남중(Kim Nam-Joong) - 성균관대학교 의과대학 삼성서울병원 내과
신동현(Sinn Dong-Hyun) - 성균관대학교 의과대학 삼성서울병원 내과
강원석(Kang Won-Seok) - 성균관대학교 의과대학 삼성서울병원 내과
백용한(Paik Yong-Han) - 성균관대학교 의과대학 삼성서울병원 내과
최문석(Choi Moon-Seok) - 성균관대학교 의과대학 삼성서울병원 내과
이준혁(Lee Joon-Hyoek) - 성균관대학교 의과대학 삼성서울병원 내과
고광철(Koh Kwang-Cheol) - 성균관대학교 의과대학 삼성서울병원 내과
백승운(Paik Seung-Woon) - 성균관대학교 의과대학 삼성서울병원 내과
곽금연(Gwak Geum-Youn) - 성균관대학교 의과대학 삼성서울병원 내과

Abstract

Background/Aims: Noninvasive diagnostic criteria for hepatocellular carcinoma (HCC) differ between guidelines, especially for subcentimeter-sized nodules. This study aimed to analyze clinical and radiological characteristics of subcentimeter-sized HCC, and assess the validity of noninvasive diagnostic criteria of the revised 2014 the Korean Liver Cancer Study Group and the National Cancer Center (KLCSG-NCC) guideline for subcentimeter-sized HCC.

Methods: A total of 33 consecutive patients (median age, 58.6 years; men, 60.6%; hepatitis B virus-infected, 87.9%) who were diagnosed with HCC between January 2009 and December 2013 and had a maximum tumor diameter less than 1 cm were retrospectively included.

Results: Among 33 subcentimeter-sized HCC cases, 6 cases were histologically proven and the remaining 27 patients were diagnosed by radiologically and/or serologically. Initial detection modality was dynamic contrast-enhanced computed tomography (CT) (66.7%, 22/33) or dynamic contrast-enhanced magnetic resonance imaging (MRI) (33.3% 11/33). No case was identified by surveillance ultrasonography. Typical radiological feature of HCC, which is arterial enhancement with delayed washout, was present in 51.7% (15/29 patients) in dynamic contrast-enhanced CT, and 90.9% (30/33 patients) in dynamic contrast-enhanced MRI. When these 33 cases were re-assessed by the revised 2014 KLCSG-NCC guideline, no one has fulfilled the noninvasive diagnostic criteria.

Conclusions: None of the cases that were diagnosed as subcentimeter-sized HCC including histologically confirmed cases did not fulfill the noninvasive diagnostic criteria of the revised 2014 KLCSG-NCC guideline. Refinement of the current noninvasive diagnostic criteria for subcentimeter-sized HCC may be required.

키워드

Diagnostic criteria, Hepatocellular carcinoma, KLCSG-NCC guideline, Subcentimeter
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
When these 33 subcentimeter-sized HCC patients were re-assessed according to the revised 2014 KLCSG-NCC guideline, no one fulfilled the noninvasive diagnostic criteria.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드