Diagnosis of liver nodules observed in chronic liver disease patients during ultrasound screening for early detection of hepatocellular carcinoma

Caturelli, Eugenio; Bartolucci, Francesca; Biasini, Elisabetta; Vigliotti, Maria Luigia; Andriulli, Angelo; Siena, D.; Attino, Vito; Bisceglia, Michele

doi:10.1111/j.1572-0241.2002.05477.x

Cited by 65 publications

(32 citation statements)

References 55 publications

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“…Because a biopsy sample is considered the gold standard for the diagnosis of cancer, we accepted this as a reference standard. It is also noteworthy that 3 studies [10][11][12] came from the same author, and there was some overlap between the study periods. Although this was not specifically stated, some patients might have been included in more than 1 study.…”

Section: Analysis Question 1 What Are the Sensitivity And Specificitmentioning

confidence: 99%

“…In Durand et al's study, 13 US-guided liver biopsy was performed with an 18-gauge needle (sometimes a 14-to 16-gauge needle was used instead), whereas in the studies by Caturelli et al, [10][11][12] a combination of histology and cytology with a fine cutting needle (ie, a 20-to 21-gauge needle) was used to establish the final diagnosis. This small needle size might explain why histology was inferior to cytology 11 (discussed later).…”

Section: Techniquementioning

confidence: 99%

“…In addition, the old AASLD guidelines 1 were analyzed (but only retrospectively). With the EASL guidelines, a noninvasive diagnosis was possible for 44 of 55 nodules (80%) with a final diagnosis of HCC; the remaining 11 nodules (20%) were diagnosed by biopsy 10 and follow-up. 1 With the old AASLD guidelines, the number of noninvasively diagnosed cases increased to 47 (85%).…”

Section: Question 4 Are There Studies Validating the Current Guidelimentioning

confidence: 99%

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Is tumor biopsy necessary?

et al. 2011

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Section: Analysis Question 1 What Are the Sensitivity And Specificitmentioning

confidence: 99%

Section: Techniquementioning

confidence: 99%

Section: Question 4 Are There Studies Validating the Current Guidelimentioning

confidence: 99%

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Is tumor biopsy necessary?

et al. 2011

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“…Regular follow-up of higher risk individuals for the early detection of HCC is routine in hospitals. 5,6 Although some community-based HCC screening projects have been reported, [7][8][9][10][11][12] to date, such screening is not common.…”

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confidence: 99%

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high‐risk for hepatocellular carcinoma

Wang

Liu

et al. 2006

Cancer

148

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BACKGROUND.The objective of this study was to examine the usefulness of platelet counts in the diagnosis of cirrhosis and for identifying high‐risk individuals in a community‐based hepatocellular carcinoma (HCC) screening program.METHODS.Pilot Study 1 determined the correlation between platelet counts and pathologic hepatic fibrosis scores among individuals with chronic hepatitis B virus (HBV) infection (n = 122 patients) and hepatitis C virus (HCV) infection (n = 244 patients). Pilot Study 2 investigated proportions of individuals with thrombocytopenia (<150 × 103/mm3) among patients with HCC (n = 4042 patients). Pilot Study 3 demonstrated the correlation between platelet counts and ultrasonographic (US) parenchyma scores among anti‐HCV‐positive individuals (n = 75 patients). The core study was a 2‐stage, community‐based screening for HCC among residents age 40 years or older in townships with a high prevalence of anti‐HCV (n = 4616 individuals) and in townships with a low prevalence of anti‐HCV (n = 1694 individuals). Patients with thrombocytopenia were identified for US and α‐fetoprotein screening.RESULTS.Among the individuals who were positive for anti‐HCV, platelet counts decreased according to increased pathologic fibrosis scores or US scores for liver parenchyma disease: The best cutoff platelet count was 150 × 103/mm3 for a diagnosis of cirrhosis. The sensitivity and specificity were 68.2% and 76.4%, respectively, for pathologic cirrhosis and 76.2% and 87.8%, respectively, for US cirrhosis. Forty‐eight percent of patients with HCC were thrombocytopenic. The proportion of thrombocytopenia was significantly greater in patients with HCV‐related HCC (63%) than in patients with HBV‐related HCC (42%). In the townships with high and low anti‐HCV prevalence, the prevalence of thrombocytopenia was 17.9% and 6.1%, respectively, (P < .001), respectively. Twenty‐five patients were diagnosed with HCC, and all of those patients resided in the high‐prevalence township.CONCLUSIONS.Thrombocytopenia was a valid surrogate of cirrhosis and a valid marker for the identification of individuals at high‐risk for HCC, especially in areas that had a high prevalence of HCV. Cancer 2006. © 2006 American Cancer Society.

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“…Geographical variation has been observed in the association between HCV and B-cell lymphomas [16,17]. A recent, large Italian series found 5 of 287 (0.31%) HCV-infected patients with liver lesions had B-cell NHL, an approximate 12-fold higher incidence than in the general population [18]. HCV is known to be lymphotropic as well as hepatotrophic, and its transcripts can be detected in CD34 + stem cells.…”

Section: Discussionmentioning

confidence: 99%

T-Cell Lymphoma of the Rectum in a Patient with AIDS and Hepatitis C: A Case Report and Discussion

2005

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Primary T-cell non-Hodgkin's lymphoma (NHL) occurring in the context of acquired immune deficiency syndrome (AIDS) is uncommon.Here, we report and discuss such a case presenting in the rectum, and review relevant literature. Although typical in some respects, the case is, in other ways, somewhat unusual for an AIDS-related NHL (ARL); ARL tends to be B cell and advanced stage and our case was T cell and stage IE. In addition, the patient suffered from concomitant cirrhosis related to hepatitis C. Chemotherapeutic options for ARL were limited early in the AIDS epidemic due to poor tolerability. Although this has largely been mitigated by the advent of highly active antiretroviral therapy, our patient eventually suffered complications of chemotherapy, apparently related more to his liver disease than to either his lymphoma or AIDS, that ultimately brought about his demise. INTRODUCTIONThe gastrointestinal (GI) tract generally is the most common site for extranodal non-Hodgkin's lymphoma (NHL), usually of the B-cell type. These NHLs may be EpsteinBarr virus (EBV) related and have long been known to be associated with immunodeficiency. Various immunodeficient states, including ataxia telangectasia, Wiskott-Aldrich syndrome, and X-linked lymphoproliferative disorder, all exhibit increased incidences of NHL. NHL is 60-100 times more common in HIV-infected patients, and B-cell NHL is an AIDS-defining illness. AIDS-related lymphomas (ARLs) show a high incidence (about 95%) of extranodal involvement, and >50% may be exclusively extranodal.

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Diagnosis of liver nodules observed in chronic liver disease patients during ultrasound screening for early detection of hepatocellular carcinoma

Cited by 65 publications

References 55 publications

Is tumor biopsy necessary?

Is tumor biopsy necessary?

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high‐risk for hepatocellular carcinoma

T-Cell Lymphoma of the Rectum in a Patient with AIDS and Hepatitis C: A Case Report and Discussion

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