Differences and similarities in the approach to hepatocellular carcinoma between Eastern and Western institutions

Torzilli, Guido; Belghiti, Jacques; Makuuchi, Masatoshi

doi:10.1002/lt.20032

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…Diagnostic tools commonly used include the serum tumor marker alfa-fetoprotein (AFP), radiographic imaging, and liver biopsy. No universal guidelines for diagnosis exist, partly as a result of marked differences in the diagnostic approach between Eastern and Western institutions [7]; however, common themes do emerge which allow for important distinctions and conclusions to be made.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of hepatocellular carcinoma

Bialecki

Bisceglie

2005

HPB

281

223

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Hepatocellular carcinoma (HCC) is responsible for a large proportion of cancer deaths worldwide. HCC is frequently diagnosed after the development of clinical deterioration at which time survival is measured in months. Long-term survival requires detection of small tumors, often present in asymptomatic individuals, which may be more amenable to invasive therapeutic options. Surveillance of high-risk individuals for HCC is commonly performed using the serum marker alfafetoprotein (AFP) often in combination with ultrasonography. Various other serologic markers are currently being tested to help improve surveillance accuracy. Diagnosis of HCC often requires more sophisticated imaging modalities such as CT scan and MRI, which have multiphasic contrast enhancement capabilities. Serum AFP used alone can be helpful if levels are markedly elevated, which occurs in fewer than half of cases at time of diagnosis. Confirmation by liver biopsy can be performed under circumstances when the diagnosis of HCC remains unclear.

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Section: Introductionmentioning

confidence: 99%

Diagnosis of hepatocellular carcinoma

Bialecki

Bisceglie

2005

HPB

281

223

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“…No single international guideline for the diagnosis of HCC exists due to marked differences in the diagnostic approach between Eastern and Western countries. 13 …”

Section: Introductionmentioning

confidence: 99%

“…12 No single international guideline for the diagnosis of HCC exists due to marked differences in the diagnostic approach between Eastern and Western countries. 13 Surgical excision of HCC provides a chance of cure for patients. Regrettably, less than one-third of patients meet the criteria for HCC resection at the time of diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Mononuclear Cells Surface Markers Evaluation in Different Stages of Hepatocellular Carcinoma; in a Trial for Early and Accurate Diagnosis in Patients with Post-Hepatitis Liver Cirrhosis and Unremarkable Raised AFP

Osman¹,

Nafady-Hego²,

Nasif³

et al. 2023

IJGM

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Introduction HCC is frequently diagnosed late, when only palliative treatment is available. So, we try to use different immunological markers to identify early HCC in patients with unremarkable raised AFP. Methods This study was conducted on 112 participants divided into two equal groups: Group I, 56 patients with liver cirrhosis and different stages of HCC; Group II, 56 patients with liver cirrhosis. The diagnosis of HCC was based on AASLD guidelines. TNM and BCLC classification systems are used for staging of HCC. Results A significant reduction in the median percentage of lymphocyte subset (CD3 + , CD4 + , CD8 + , CD19 + ) and NK cell percentage (CD56 + ) has been detected in HCC patients (all P < 0.001). In the HCC group the median monocyte subpopulations CD14 + CD16 − Classical, CD14 ++ CD16 + Intermediate, and CD14 −+ CD16 ++ Non-Classical were 11.7, 4.0, and 3.5, respectively, with marked reduction compared with liver cirrhosis group (all P < 0.001). Patients with advanced stages (BCLC C and D) were more likely to have significantly higher median CD33 + than patients with early stages (BCLC A and B) ( P = 0.05); also, the median levels of HLA DR + lymphocytes % in the HCC case group were 21.8 in patients with advanced disease (BCLC C and D) and 13.1 in patients with early stages of the disease ( P = 0.04). Patients with late stage (TNM III) were more likely to have significantly higher median CD14 + CD16 − Classical monocyte subset, CD36 + HLA DR + , and CD36 + CD16 − than patients with early stages (TNM I and II). Conclusion Patients with HCC with unremarkable raised AFP showed marked reduction in lymphocytes, natural killer cells, and all monocyte subpopulations. In addition, patients with advanced HCC showed increased CD33 + and HLA DR + lymphocytes %, CD14 + CD16 − Classical monocyte subset, CD36 + HLA DR + , and CD36 + CD16 − compared with patients with early stages of HCC.

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“…The etiology of HCC has been reported to be linked to several types of diseases, such as chronic hepatitis C [ 2 ], alcoholic hepatitis [ 3 ], non-alcoholic steatohepatitis (NASH) [ 4 ], diabetes mellitus and metabolic syndrome [ 5 ]. The diagnostic strategies for identifying early HCC remain the subject of many studies and are defined by the tumor size and the number of lesions [ 6 ]. The most common methods used to diagnose HCC are radiographic imaging, liver biopsy and measurement of the serum tumor marker alpha-fetoprotein (AFP) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The diagnostic strategies for identifying early HCC remain the subject of many studies and are defined by the tumor size and the number of lesions [ 6 ]. The most common methods used to diagnose HCC are radiographic imaging, liver biopsy and measurement of the serum tumor marker alpha-fetoprotein (AFP) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Telomerase Inhibition Decreases Alpha-Fetoprotein Expression and Secretion by Hepatocellular Carcinoma Cell Lines: In Vitro and In Vivo Study

et al. 2015

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Alpha-fetoprotein (AFP) is a diagnostic marker for hepatocellular carcinoma (HCC). A direct relationship between poor prognosis and the concentration of serum AFP has been observed. Telomerase, an enzyme that stabilizes the telomere length, is expressed by 90% of HCC. The aim of this study was to investigate the effect of telomerase inhibition on AFP secretion and the involvement of the PI3K/Akt/mTOR signaling pathway. Proliferation and viability tests were performed using tetrazolium salt. Apoptosis was determined through the Annexin V assay using flow cytometry. The concentrations of AFP were measured using ELISA kits. The AFP mRNA expression was evaluated using RT-PCR, and cell migration was evaluated using a Boyden chamber assay. The in vivo effect of costunolide on AFP production was tested in NSG mice. Telomerase inhibition by costunolide and BIBR 1532 at 5 and 10 μM decreased AFP mRNA expression and protein secretion by HepG2/C3A cells. The same pattern was obtained with cells treated with hTERT siRNA. This treatment exhibited no apoptotic effect. The AFP mRNA expression and protein secretion by PLC/PRF/5 was decreased after treatment with BIBR1532 at 10 μM. In contrast, no effect was obtained for PLC/PRF/5 cells treated with costunolide at 5 or 10 μM. Inhibition of the PI3K/Akt/mTOR signaling pathway decreased the AFP concentration. In contrast, the MAPK/ERK pathway appeared to not be involved in HepG2/C3A cells, whereas ERK inhibition decreased the AFP concentration in PLC/PRF/5 cells. Modulation of the AFP concentration was also obtained after the inhibition or activation of PKC. Costunolide (30 mg/kg) significantly decreased the AFP serum concentration of NSG mice bearing HepG2/C3A cells. Both the inhibition of telomerase and the inhibition of the PI3K/Akt/mTOR signaling pathway decreased the AFP production of HepG2/C3A and PLC/PRF/5 cells, suggesting a relationship between telomerase and AFP expression through the PI3K/Akt/mTOR pathway

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Differences and similarities in the approach to hepatocellular carcinoma between Eastern and Western institutions

Cited by 4 publications

References 20 publications

Diagnosis of hepatocellular carcinoma

Diagnosis of hepatocellular carcinoma

Peripheral Mononuclear Cells Surface Markers Evaluation in Different Stages of Hepatocellular Carcinoma; in a Trial for Early and Accurate Diagnosis in Patients with Post-Hepatitis Liver Cirrhosis and Unremarkable Raised AFP

Telomerase Inhibition Decreases Alpha-Fetoprotein Expression and Secretion by Hepatocellular Carcinoma Cell Lines: In Vitro and In Vivo Study

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