Screening and early treatment of primary liver cancer--with special reference to the east part of China.

The discovery of tumor marker alpha-foetoprotein (AFP) in hepatocellular carcinoma (HCC) and its application in screening has greatly contributed to early diagnosis. Of the more than five million natural population screened in our country since 1971, over one thousand cases of HCC have been detected. The percentage of subclinical cancer has been increased to 60.7% since passive reverse hemagglutination test was employed as initial screening in 1974. Diagnosis of subclinical HCC by AFP depends upon its absolute value, its serial change and interrelationship between serial change of AFP and SGPT. Subclinical HCC only amounted to 0.4-0.9% in clinical cases, but it went up to 44.7-71.2% in mass survey patients. Small HCC also rarely occurred in literature, however, the number of cases of small HCC resected has exceeded one hundred in our country, it amounting to 56.8-72.7% of the resected cases in mass survey patients. Results of a comparative study of mass survey and clinical patients demonstrated that 1-year, 2-year and 3-year survival being 14.8%, 7.4% and 5.5% and in clinical patients; 45.2%, 16.4% and 4.1% in mass survey patients who received conservative treatment; and 79.1%, 67.8% and 61.6% who received surgical resection. Unsolved problems and future prospects were also discussed.