Published online Oct 15, 1998. doi: 10.3748/wjg.v4.iSuppl2.108
Revised: August 8, 1998
Accepted: August 30, 1998
Published online: October 15, 1998
AIM: To distinguish primary hepatic carcinoma with extrahepatic metastasis from secondary hepatic carcinoma (SHC).
METHODS: Eighty-nine in patients with confirmed primary hepatic carcinoma with extrahepatic metastasis and secondary hepatic carcinoma in the period of November 1992 to May 1996, were reviewed, the shape diameter number of intrahepatic cancer nests, serum AFP, CA19.9 and CEA levels were compared.
RESULTS: There were 17 cases (19.1%) PHCEHM and 72 cases (80.9 %) SHC in this group. There were 9 cases (52.9%) with pulmonang metastasis, 3 cases (17.6%) with bone metastasis and 5 cases (29.4%) woth other organ metastasis. In SHC there were 30 hepatic metastasis (41.7%) from gastric carcinoma 27 cases (37.5%) from lung carcinoma, 8 cases (11.1%) from pancreas carcinoma, and 7 cases (9.7%) from other carcinoma. Examination by CT scan showed in primary hepatic carcinoma that single cancer nests in 10 cases (58.8%), satellite cancer nests in 7 cases (41.2%); and in secondary hepatic carcinoma single cancer nest in 3 cases (4.2%), satellite cancer nests 8 cases (11.1%), the other 61 cases (84.7%) were multicancer nests with equalsize. In primary hepatic carcinoma 15 were AFP positive, and CA19.9 + CEA were the negative, CA19.9 + CEA of the rest 2 cases were positive, including 1 cholangiocellular cancer all was AFP negative, and 1 mixed hepatocellular cancer was AFP positive. In SHC CA19.9 + CE A were positive, AFP negative in 69 cases, AFP positive in 3 cases.
CONCLUSION: The results indicated that of the cases with intrahepatic and extahepatic cancer nests 80.9% were SHC. Cases with intrahepatic single cancer nests, and serum AFP positive and CA19.9 + CEA negative, were in generall PHC, or else SHC. It was difficult to distinguish AFP-positive SHC, cholangiocellular carcinoma and mixed hepatocellular cancer accounting 5.6% (5/89) totally, which should be identified by pathological examination of extrahepatic or intrahepatic cancer nests. These results can serve as a reference for clinicians to make differential diagnosis of primary hepatic carcinoma with extrahepatic metastasis from secondary hepatic carcinoma.