우리나라 간경변증 환자에서 원발성 간암 발생률 및 이에 영향을 미치는 인자들에 관한 전향적 연구

This prospective, longitudinal study was to determine the incidence of hepatocellular carcinoma (HCC) and the risk factors of the development of HCC in patients with liver cirrhosis in Korea. We enrolled 285 patients with liver cirrhosis who had experienced the esophageal variceal bleeding and had been treated by endoscopic injection sclerotherapy in our hospital and survived more than 3 months. They were closely followed up with ultrasonography (USG) of the liver and determination of serum alpha-fetoprotein (a-FP) levels for the detection of HCC. The mean age of the patients at the time of the first episode of esophageal variceal bleeding was 47.9+-9.6 with the male to female ratio of 3.75:1. The positive rate of serum HBsAg was 64.6% and decreased with aging. The cumulative incidence was 2.6%, 6.7%, 12 3%, 18.8% and 21.5% in 1, 2, 3, 4 and 5 years, respectively. The annual incidence of HCC in HBsAg positive and negative patients was 5.2% and 2.4%, respectively and the difference was statistically significant (p50 years) was significantly higher than that of younger (3.2%). The annual incidence in male patients (4.5%) was likely to be higher than in female (2.8%) though the difference was not statistically significant. In conclusion, the high incidence of HCC in patients with liver cirrhosis was reconfirmed by prospective study. HBsAg positivity, old age (above 50 years) and male sex turned out to be factors which increased the risk of the development of HCC.