Albrecht T
Klinik und Hochschulambulanz für Radiologie und Nuklearmedizin, Charité-Unversitätsmedizin, Freie Universität und Humboldt-Universität zu Berlin, Berlin, Deutschland.
Radiologe. 2008 Jan;48(1):33-8. doi: 10.1007/s00117-007-1590-9.
Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP.
肝细胞癌（HCC）是全球最常被诊断出的肿瘤疾病之一。在绝大多数情况下，患者为患有慢性病毒性肝炎和/或肝硬化的高危患者，这意味着HCC筛查有明确的目标人群。通过切除、移植和局部消融的介入治疗，早期诊断后有治愈性治疗选择，5年生存率可达60%以上。然而，这种早期诊断仅在少数患者中得以实现，在大多数情况下，疾病在诊断时已处于晚期。HCC筛查的目标之一是在仍有可能进行治愈性治疗的早期阶段进行诊断。筛查恰恰实现了这一点，从而使接受治愈性治疗的患者比例明显更高。目前尚无明确证据表明这是否会降低HCC的死亡率。由于较低的死亡率是筛查计划成功的决定性指标，迄今为止，HCC筛查的益处既未得到证实，也未被反驳。尽管如此，在世界上的大片地区，高危患者的做法是以每年两次超声检查和甲胎蛋白测定的形式进行HCC筛查。
