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Guide for diagnosis and treatment of hepatocellular carcinoma

World Journal of Hepatology 2015年第12期7卷 1632-1651页

作者： Magdy Hamed Attwa Shahira Aly El-Etreby Division of Hepatology and Gastroenterology Specialized Medical Hospital Faculty of Medicine Mansoura University

Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis determined by several factors; tumour extension, alpha-fetoprotein(AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound(US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography(CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.

关键词： Diagnosis of hepatocellular carcinoma Surgical resection Hepatocellular carcinoma Livertransplantation radiofrequency ablation Microwaveablation Percutaneous ethanol or acetic acid ablation radio-embolisation Systemic chemotherapy Transarterialchemoembolisation

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