Current and Emerging Tools for Hepatocellular Carcinoma Surveillance.
Current and Emerging Tools for Hepatocellular Carcinoma Surveillance.
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DOI：
10.1002/hep4.1823
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发表时间：
2021-12
影响因子：
5.1
通讯作者：
Dhanasekaran R
中科院分区：
文献类型：
--
作者：
Adeniji N;Dhanasekaran R
肝细胞癌（HCC）是全球癌症相关死亡率的主要原因。HCC的早期检测使患者能够获得可以改善患者生存的治愈性治疗。目前的国际指南提倡将HCC高危患者（如肝硬化患者）纳入监测计划，每6个月进行一次超声检查。近年来，许多研究进一步描述了已建立的筛查策略的实用性，并为HCC监测引入了新的有前途的工具。在这篇综述中，我们提供了一个最有前途的新的成像方式和生物标志物检测肝癌的概述。我们讨论了超声、计算机断层扫描（CT）和磁共振成像（MRI）等成像工具在HCC早期检测中的作用，并描述了最近的创新，这些创新可能会增强其适用性，包括对比增强超声、低剂量CT扫描和简化MRI。接下来，我们概述了支持使用三种循环生物标志物的数据（即，甲胎蛋白[AFP]、AFP透镜凝集素反应性分数和脱-γ-羧基凝血酶原）在HCC监测中的作用，并扩展了多种新兴的液体活检生物标志物，包括甲基化无细胞DNA（cfDNA）、cfDNA突变、细胞外囊泡和循环肿瘤细胞。这些有前途的新的成像方式和生物标志物有可能改善HCC患者的早期检测，从而提高生存率。由于对筛查指南的依从性差，更重要的是缺乏高度敏感和特异性的筛查工具，HCC是一种在早期阶段检测的具有挑战性的疾病。超声、计算机断层扫描（CT）和磁共振成像（MRI）技术的最新进展已经提高了检测的灵敏度和特异性，但它们在很大程度上受到成本、安全性和可用性的阻碍。HCC监测的未来可能在于循环液体活检生物标志物，这些生物标志物有可能在全球人群中以成本效益和非侵入性方式实施。
Hepatocellular carcinoma (HCC) is a leading cause of cancer‐related mortality worldwide. Early detection of HCC enables patients to avail curative therapies that can improve patient survival. Current international guidelines advocate for the enrollment of patients at high risk for HCC, like those with cirrhosis, in surveillance programs that perform ultrasound every 6 months. In recent years, many studies have further characterized the utility of established screening strategies and have introduced new promising tools for HCC surveillance. In this review, we provide an overview of the most promising new imaging modalities and biomarkers for the detection of HCC. We discuss the role of imaging tools like ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) in the early detection of HCC, and describe recent innovations which can potentially enhance their applicability, including contrast enhanced ultrasound, low‐dose CT scans, and abbreviated MRI. Next, we outline the data supporting the use of three circulating biomarkers (i.e., alpha‐fetoprotein [AFP], AFP lens culinaris agglutinin‐reactive fraction, and des‐gamma‐carboxy prothrombin) in HCC surveillance, and expand on multiple emerging liquid biopsy biomarkers, including methylated cell‐free DNA (cfDNA), cfDNA mutations, extracellular vesicles, and circulating tumor cells. These promising new imaging modalities and biomarkers have the potential to improve early detection, and thus improve survival, in patients with HCC. HCC is a challenging disease to detect in the early stages due to poor adherence to screening guidelines, and more importantly, a paucity of highly sensitive and specific screening tools. Recent advances in ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) techniques have improved upon the sensitivity and specificity for detection, but they are in large part hindered by cost, safety and availability. The future of HCC surveillance likely lies in circulating liquid biopsy biomarkers which have the potential to be cost‐effectively and non‐invasively implemented in populations worldwide.
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影响因子：
12.6
作者：
Best, Jan;Bechmann, Lars P.;Canbay, Ali
通讯作者：
Canbay, Ali
影响因子：
64.5
作者：
Cancer Genome Atlas Research Network. Electronic address: wheeler@bcm.edu;Cancer Genome Atlas Research Network
通讯作者：
Cancer Genome Atlas Research Network
DOI：
10.1148/rycan.2019190010
发表时间：
2019-11-01
期刊：
RADIOLOGY-IMAGING CANCER
影响因子：
--
作者：
Brunsing, Ryan L.;Chen, Dennis H.;Sirlin, Claude B.
通讯作者：
Sirlin, Claude B.
影响因子：
12.6
作者：
Berhane, Sarah;Toyoda, Hidenori;Johnson, Philip
通讯作者：
Johnson, Philip
影响因子：
13.5
作者：
Atiq, Omair;Tiro, Jasmin;Singal, Amit G.
通讯作者：
Singal, Amit G.