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원발성 간암의 임상적 고찰

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 (A) clinical study of primary carcinoma of the liver 
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1965년 1월부터 1975년 5월까지 연세대학교 부속 세브란스병원에 입원한 원발성간암 환자 711예를 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다.

환자는 40대, 50대가 대부분이었고 남자가 여자의 5배로 많았다. 초발증상은 복통이 가장 많았으며 이학적소견상 간종대가 가장 많았다. 혈청 AFP는 57.5 %에서 양성이었고 혈청 Cholesterol치가 높을수록 양성율이 높았다. 세포형은 93.4 %가 간암세포이었고 간경

변증은 73.6 %에서 있었다. 원격전이는 수술적으로 또는 검사소견상 17.0 %에서 나타났고 폐전이가 가장 많았다.

경과중 사망한 환자는 45예였으며 이중 71.2%가 3개월 이내에 사망하였고 사망원인은 간성흔수가 가장 많았다.


We have presented a clinical study of 711 cases with primary carcinoma of the liver during the period between January 1965 and May 1975. The results of the clinical study on there cases are as follows :

1. 65.9% of the patients with primary cardinoma of the liver were in the 5th -6th decade of life.

There was significant difference between the sexes ; 83.3% were males and 16.7% were females.

2. Hepatomegaly was the most frequent physical finding and found in 81.4% and spleen was palpable in 10.7%.Jaundice, abdominal pain were also not infrequent.

3. BSP retension, elevated alkaline phosphatase and elevated SGOT were relatively frequent laboratory findings. The serum AFP was positive in 57.5%.

4. Those patients with high serum cholesterol level had much higher AFP positive rate than those with serum cholesterol level. Seventy percent of the patients with more than 300 mg% of serum total cholesterol were AFP positive and there were no AFP negative patients with nore than 500 mg% of serum total cholesterol.

5. Hepatocellular carcinoma was predominant (93.4%), while cholangioma was 6.2% and primary carcinoma of the liver was associated with liver cirrhosis in 73.6% of the patients.

6. Various kinds of liver diseases were observed in 30.0% of the patients before the onset of the primary carcinoma of the liver. Clonorchiasis was the most frequent of these (11.1%)

7. Remote metastasis was observed in 17.0% and pulmonary metastasis was the most frequent and was seen on 12.1% of the patients.

8. There was usually rapidly fatal course in the patients and 91.1% of the patients had than 6 months of symptoms before diagnosis. Hepatic coma was the most frequent cases of death and 71.2% of the patients died within 3 months from the onset of the symptome.
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