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Hepatocellular carcinoma surveillance:An evidence-based approach

World Journal of Gastroenterology 2019年第13期25卷 1550-1559页

作者： Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire Mohamed G Shoreibah tinsley harrison internal medicine residency Program Department of Medicine University of Alabama at Birmingham Division of Gastroenterology and Hepatology Department of Medicine University of Alabama at Birmingham

Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC *** investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.

关键词： Liver cancer Hepatocellular carcinoma Surveillance

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Severe Alcoholic Hepatitis:Atypical Presentation with Markedly Elevated Alkaline Phosphatase

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Journal of Clinical and Translational Hepatology 2017年第4期5卷 414-415页

作者： Page Axley Kirk Russ Ashwani K.Singal tinsley harrison internal medicine residency Program University of Alabama at BirminghamBirminghamALUSA Division of Gastroenterology and Hepatology University of Alabama at BirminghamBirminghamALUSA

Alcoholic hepatitis(AH)is an acute inflammatory liver disease with poor *** in AH are difficult to detect and contribute to short-term *** cholestasis and elevated alkaline phosphatase levels are also associated with ... 详细信息

关键词： Alcoholic hepatitis Alcoholic liver disease Alkaline phosphatase Cholestatic liver disease

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A focused review on recent advances in diagnosis and management of fibrolamellar hepatocellular carcinoma

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Hepatoma Research 2022年第1期8卷 284-300页

作者： Mahmoud Aryan Nicholas Forrister Nishah Panchani Bijal Vashi Zahara Chowdhury Haider A.Mejbel Mohamed Shoreibah tinsley harrison internal medicine residency Department of MedicineUniversity of Alabama at Birmingham17202nd Avenue SouthBDB 327BirminghamAL 35294USA University of Alabama at Birmingham School of medicine Department of Medicine17202nd Ave S.BirminghamAL 35294USA University of Mississippi Medical Center School of medicine Department of Medicine2500 N State St.JacksonMS 39213USA Division of Surgical and Molecular Genetics Pathology Department of PathologyUniversity of Alabama at Birmingham61919th St SBirminghamAL 35233USA Division of Gastroenterology and Hepatology Department of MedicineUniversity of Alabama at Birmingham18087th Avenue SouthBDB 391BirminghamAL 35294USA

Fibrolamellar hepatocellular carcinoma(FHCC)is a rare primary malignancy of the liver for which data remain *** tumor is more often diagnosed in younger patient populations in the absence of underlying cirrhosis and *** lesions can be diagnosed on computed tomography scan or magnetic resonance imaging with common findings including central calcifications,a central stellate scar,and radiating fibrotic *** markers have not proved useful for diagnosis;however,pathologic analysis can be implemented to aid in diagnosis with findings including ample granular eosinophilic cytoplasm,nuclei with open chromatin and prominent macronuclei,hyaline and pale bodies,and dense lamellar fibrosis that divides the cells into cords or *** demonstrates aggressive malignant potential with nodal *** patterns have remained mainly surgical;however,systemic therapies have been implemented and are under further investigation with clinical *** therapies and radiation therapies have been trialed *** this focused review,we discuss the most up-to-date perspective on epidemiology,clinical presentation,diagnostic approach,differential diagnosis,treatment regimens,prognosis,and future directions of FHCC.

关键词： Fibrolamellar hepatocellular carcinoma diagnosis treatment surgery systemic histology review

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