Alpha-foetoprotein and/or liver ultrasonography for screening of hepatocellular carcinoma in patients with chronic hepatitis B

Aghoram, Rajeswari; Cai, Pin; Dickinson, James A

doi:10.1002/14651858.cd002799.pub2

Cited by 73 publications

(64 citation statements)

References 49 publications

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“…However, a successful ultrasounddetection relies on the expertise of the physician, the available of ultrasound equipment, and the echo texture of the liver. So the actual sensitivity and specificity of ultrasound-detection is difficult to evaluate due to the lack of standard in China (36,37). Serum biomarkers are striking prospective alternative tools for screening and early diagnosis of HCC thanks to the non-invasive, objective, and reproducible assessments they would enabled (38).…”

Section: Evidence For Exploration Of Using Dcp In Early Hcc Detectionmentioning

confidence: 99%

Perspectives on a combined test of multi serum biomarkers in China: Towards screening for and diagnosing hepatocellular carcinoma at an earlier stage

Zhang¹,

Song

Gao

et al. 2014

DD&T

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Section: Evidence For Exploration Of Using Dcp In Early Hcc Detectionmentioning

confidence: 99%

Perspectives on a combined test of multi serum biomarkers in China: Towards screening for and diagnosing hepatocellular carcinoma at an earlier stage

Zhang¹,

Song

Gao

et al. 2014

DD&T

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“…7 HCC screening brings remarkable survival benefits to high-risk subjects by early detection, which is the reason that it is clinically very important. 8,9 However, the HCC screening rate has been reported to be low (only 23% in Korea among high-risk groups). 10 Improvements in HCC screening via the identification of subpopulations at particularly high risk (high enough to make regular screening cost-effective) would be highly beneficial.…”

Section: Introductionmentioning

confidence: 99%

Prediction of future hepatocellular carcinoma incidence in moderate to heavy alcohol drinkers with the FIB‐4 liver fibrosis index

Suh

Yun

Park³

et al. 2015

Cancer

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BACKGROUND: Although heavy alcoholics are at heightened risk for hepatocellular carcinoma (HCC), there are no guidelines that recommend HCC screening for heavy alcoholics. This study investigated FIB-4, a noninvasive and easily applicable liver fibrosis index, as a risk factor for HCC incidence among alcohol drinkers without viral hepatitis. METHODS: This retrospective cohort study included 6661 generally healthy adults who were 30 years old or older, did not have chronic viral hepatitis, and visited Seoul National University Hospital for a general, routine health evaluation. The future HCC incidence was determined from National Health Insurance medical service claims data (median follow-up, 6.2 years). RESULTS: With adjustments for age, sex, body mass index, smoking, and alcohol, compared with subjects with FIB-4 values less 1.00, subjects with FIB-4 values greater than or equal to 1.75 and less than 2.10 and subjects with FIB-4 values greater than or equal to 2.10 had adjusted hazard ratios (aHRs) of 5.18 (95% confidence interval [CI], 1.12-24.00) and 13.63 (95% CI, 3.77-49.33), respectively, for HCC incidence. This was heightened in subjects who drank more 30 g of alcohol per day: the aHRs were 8.39 (95% CI, 1.28-54.87) and 16.58 (95% CI, 3.87-71.04), respectively. FIB-4 was shown to have a higher predictive value for HCC incidence than ultrasonographically detected liver cirrhosis (C-index, 0.665 vs 0.527; P 5.044). CON-CLUSIONS: High FIB-4 is a risk factor with a high predictive value for HCC incidence, especially among moderate to heavy alcoholics (>30 g/d). FIB-4 is a readily available and probably cost-effective clinical tool with potential value for identifying subpopulations of alcoholics at particularly high risk who would benefit from regular HCC screening. Further investigations are warranted to validate our results; nonetheless, our study suggests that FIB-4 may be useful in HCC screening among alcoholics. Cancer 2015;121:3818-25.

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“…The combination of these strategies increases the number of false positives as well as costs. There is currently insufficient evidence to support or refute the use of both methods in HCC screening/surveillance in the population with hepatitis B infection [44,48] .…”

Section: Serum Alpha Fetoprotein (Afp)mentioning

confidence: 99%

Diagnosis and treatment of hepatocellular carcinoma: An update

Tejeda-Maldonado¹

2015

WJH

110

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Hepatocellular carcinoma (HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium "washout" in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and locoregional therapies (alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. Core tip: This paper reviews the most recent evidence on hepatocarcinoma including its molecular pathogenesis and prognosis, with special emphasis on its diagnosis, staging and treatment. The most recent Easter and Western international guidelines are also reviewed.

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Alpha-foetoprotein and/or liver ultrasonography for screening of hepatocellular carcinoma in patients with chronic hepatitis B

Abstract: Alpha-foetoprotein and/or liver ultrasonography for screening of hepatocellular carcinoma in patients with chronic hepatitis B.

Cited by 73 publications

References 49 publications

Perspectives on a combined test of multi serum biomarkers in China: Towards screening for and diagnosing hepatocellular carcinoma at an earlier stage

Perspectives on a combined test of multi serum biomarkers in China: Towards screening for and diagnosing hepatocellular carcinoma at an earlier stage

Prediction of future hepatocellular carcinoma incidence in moderate to heavy alcohol drinkers with the FIB‐4 liver fibrosis index

Diagnosis and treatment of hepatocellular carcinoma: An update

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