LAPAROSCOPIC PREDICTION OF HEPATOCELLULAR-CARCINOMA IN CIRRHOSIS PATIENTS

Previously, laparoscopic studies have not been successful in predictin g the occurrence of small hepatocellular carcinoma because cirrhotic p atients had not been separated into groups of those who developed smal l hepatocellular carcinoma under 3 cm in diameter, and those who did n ot. Retrospective examination with. better separation of the mio group s gave improved results. Of the 26 laparoscopic findings, only the pre sence of large complex regenerative nodules was closely associated wit h the occurrence of subclinical small hepatocellular carcinoma. The st udy of other cirrhotic patients with and without large complex regener ative nodules gave a cumulative hepatocellular carcinoma occurrence ra te of 73% for patients who had these nodules by the third year after l aparoscopy. In contrast, the rate for patients without such nodules wa s 6%, showing a significant difference (P < 0.05) between the two grou ps. We concluded that the laparoscopic finding of large complex regene rative nodules of liver cirrhosis can be used to predict the occurrenc e, or a complication, of subclinical small hepatocellular carcinoma.