Division of Gastroenterology and Hepatology, Henry Ford Hospital, 2799 West Grand Boulevard, Suite K7, Detroit, MI 48202, USA.
Med Clin North Am. 2014 Jan;98(1):103-18. doi: 10.1016/j.mcna.2013.09.003. Epub 2013 Oct 18.
Patients with cirrhosis are at greatest risk for development of hepatocellular carcinoma (HCC) and should undergo semiannual surveillance using ultrasound, with or without alpha fetoprotein. Patients with positive surveillance testing should undergo contrast-enhanced MRI or 4-phase CT for diagnostic evaluation. There are therapeutic options for most patients with any tumor stage; however, treatment decisions must be individualized after accounting for degree of liver dysfunction and patient performance status. A multidisciplinary approach to care is recommended for optimal communication and treatment delivery. The aim of this review is to provide an up-to-date summary of the diagnosis and management of HCC.
肝硬化患者发生肝细胞癌(HCC)的风险最高,应使用超声(无论是否结合甲胎蛋白)每半年进行一次监测。监测结果阳性的患者应进行增强 MRI 或 4 期 CT 检查以进行诊断评估。大多数任何肿瘤分期的患者都有治疗选择;然而,在考虑肝功能不全程度和患者体能状态后,必须对治疗决策进行个体化。建议采用多学科治疗方法以实现最佳的沟通和治疗效果。本综述的目的是提供 HCC 诊断和管理的最新总结。