HEPATOCELLULAR-CARCINOMA - UPDATE ON DIAGNOSIS AND TREATMENT

被引:50
作者
RAMSEY, WH
WU, GY
机构
[1] Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut School of Medicine, Farmington, CT
关键词
HEPATOCELLULAR CARCINOMA; HEPATOMA; ALPHA-FETOPROTEIN;
D O I
10.1159/000171490
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
In this review, the current approach to the screening, diagnostic evaluation, staging, and treatment for hepatocellular carcinoma (HCC) is outlined. The serum alpha-fetoprotein (AFP) level and abdominal ultrasonography (US) remain the cornerstones of screening protocols for HCC. Other serum marker proteins, such as abnormal serum prothrombin (PIVKA-II), when used in conjunction with AFP, can increase the yield for HCC. For diagnosis and staging of HCC, other imaging modalities employed include CT scan, infusion hepatic angiography, CT with arterial portography or iodized oil enhancement, MRI with contrast enhancement, intraoperative US, and US-guided fine-needle aspiration cytology and biopsy. Treatment options which have afforded some improvement in survival and tumor regression include surgical resection, orthotopic liver transplantation, percutaneous injection of ethanol, arterial chemoembolization, cryotherapy, and systemic or regional chemotherapy. Despite these advances, the diagnosis of HCC still portends a dismal prognosis.
引用
收藏
页码:81 / 91
页数:11
相关论文
共 65 条
[1]  
Di Bisceglie A.M., Rustgi V.K., Hoof-Naglc J.H., Dushciko G.M., Lotze M.T., Hepatocellular carcinoma, Ann Intern Med, 108, pp. 390-401, (1988)
[2]  
Tsukuma H., Hiyama T., Tanaka S., Nakao M., Yabuuchi T., Kitamura T., Nakanishi K., Fujimoto I., Inoue A., Yamazaki H., Kawashima T., Risk factors for hepatocellular carcinoma among patients with chronic liver disease, N Engl J Med, 328, pp. 1797-1801, (1993)
[3]  
Colombo M., De Franchis R., Del Ninno E., Sangiovanni A., De Fazio C., Tommasini M., Donato M.F., Piva A., Di Carlo V., Dioguardi N., Hepatocellular carcinoma in Italian patients with cirrhosis, N Engl J Med, 325, pp. 675-680, (1991)
[4]  
Imberti D., Fomari F., Sbolli G., Bus-Cami E., Squassante L., Buscarni L., Hepatocellular carcinoma in liver cirrhosis, Scand J Gastroenterol, 28, pp. 540-544, (1993)
[5]  
Parkin D.M., StjemswardJ. MuirCS: Estimates of the worldwide frequency of twelve major cancers, Bull WHO, 62, pp. 163-182, (1984)
[6]  
Spivey J.R., Gores G.J., Risk factors and screening for hepatocellular carcinoma, Comp Ther, 18, pp. 5-9, (1992)
[7]  
Villcneuvc J.-P., Desrochcrs M., In-Fantc-Rivard C., Willems B., Raymond G., Bourcicr M., Cote J., Richer G., A long-term follow-up study of asymptomatic hepatitis B surface antigen positive carriers in Montreal, Gastroenterology, 106, pp. 1000-1005, (1994)
[8]  
Ebara M., Ohto M., Shinagawa T., Su-Giura N., Kimura K., Matsutani S., Morita M., Saisho H., Tsuchiya Y., Okuda K., Natural history of minute hepatocellular carcinoma smaller than three centimeters complicating cirrhosis, Gastroenterology, 90, pp. 289-298, (1986)
[9]  
Cottone M., Virdone R., Fusco G., Orlando A., Turri M., Caltagirone M., Maringhini A., Sciarrino E., Demma I., Nicoli N., Tine F., Sammarco S., Pagliaro L., Asymptomatic hepatocellular carcinoma in Child's A cirrhosis, Gastroenterology, 96, pp. 1566-1571, (1989)
[10]  
Alpert M.E., Hutt M., Davidson C.S., Primary hepatoma in Uganda, Am J Med, 46, pp. 794-802, (1969)