Issues in screening and surveillance for hepatocellular carcinoma
Issues in screening and surveillance for hepatocellular carcinoma
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DOI：
10.1053/j.gastro.2004.09.022
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发表时间：
2004-11-01
期刊：
影响因子：
29.4
通讯作者：
Di Bisceglie, AM
中科院分区：
文献类型：
--
作者：
Di Bisceglie, AM
患有慢性病毒性肝炎和其他形式的肝病的个体有发生肝细胞癌（HCC）的风险。当HCC出现临床症状时，肿瘤通常非常晚期，患者几乎没有治疗选择。因此，筛查和监测HCC似乎是非常合适的。然而，没有明确的证据表明，监督改善患者的结果和目前的技术缺乏敏感性和特异性。尽管如此，血清和肝脏超声中甲胎蛋白（AFP）水平的系列测量已成为常规做法，尽管缺乏证据表明其整体效益。显然，需要更好的方法来早期诊断HCC。在被广泛推荐之前，改进的技术最终必须经过测试，以改善患者的预后。
Individuals with chronic viral hepatitis and other forms of liver disease are at risk for developing hepatocellular carcinoma (HCC). When HCC presents with clinical symptoms, the tumor is typically very far advanced and the patient has few therapeutic options. Thus, screening and surveillance for HCC would appear to very appropriate. However, there is no definitive evidence that survelance improves patient outcomes and current techniques lack sensitivity and specificity. Nonetheless, serial measurement of alpha-fetoprotein (AFP) levels in serum and hepatic ultrasound have become routine practice, despite a lack of evidence of their overall benefit. Clearly, better methods are needed for early diagnosis of HCC. Improved technology will ultimately have to be tested for improved patient outcome before becoming widely recommended.