Utility of screening for hepatocellular carcinoma among cirrhotics

Niravath, Polly; Hayes, Teresa G.; Hilsenbeck, Susan G.

doi:10.1136/fg.2010.003244

Cited by 1 publication

(1 citation statement)

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“…Early diagnosis and work-up is particularly important today, given the new medical technologies and medications directed at safely eradicating HCV [32] and halting the progression of chronic severe HBV (nucleoside/nucleotide analogues) [33] and possibly NAFLD [34,35]. Additionally, liver cirrhosis is associated with a high risk of morbidity and mortality from liver insufficiency or hepatocellular carcinoma [36,37], and its early detection can lead to curative treatment [38].…”

Section: Discussionmentioning

confidence: 99%

Lowering the upper limit of serum alanine aminotransferase levels may reveal significant liver disease in the elderly

et al. 2019

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This study sought to determine the prevalence of significant liver disease in those subjects with serum alanine aminotransferase levels in the range between the current and the newly suggested upper limit of normal (termed the delta range). The files of the previous study subjects (who underwent at least one alanine aminotransferase measurement in 2002 and followed to 2012) were reviewed for a diagnosis of chronic liver disease; aspartate aminotransferase/platelet ratio index, FIB-4 and alanine aminotransferase/aspartate aminotransferase ratio were used to evaluate liver fibrosis. The prevalence of significant liver disease, by diagnoses and fibrosis scores was compared between subjects with alanine aminotransferase levels in the delta range (men, 42–45 IU/L; women, 26–34 IU/L) and in the newly suggested normal range (men, 15–42 IU/L; women, 10–26 IU/L). The cohort included 49,634 subjects (41% male, mean age 83±6 years) of whom 2022 were diagnosed with chronic liver disease including 366 with cirrhosis. Compared to subjects with alanine aminotransferase levels in the newly suggested normal range, subjects with alanine aminotransferase levels in the delta range had a significantly higher rate of chronic liver disease (men, 15.3% vs. 4.9%; women, 7.8% vs. 3.3%) and of cirrhosis specifically (men, 4.2% vs. 0.9%; women, 1.5% vs. 0.4%) and also had higher mean fibrosis scores (P <0.001 for all). Lowering the current upper limit of normal of serum alanine aminotransferase may help to identify elderly patients at risk of significant liver disease.

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