Mehta Neil J, Celik Aygul Dogan, Peters Marion G
Department of Medicine University of California San Francisco CA.
Department of Infectious Diseases and Clinical Microbiology Trakya University School of Medicine Edirne Turkey.
Hepatol Commun. 2016 Dec 19;1(1):18-22. doi: 10.1002/hep4.1014. eCollection 2017 Feb.
While there are guidelines from all major liver societies for the screening and management of hepatocellular carcinoma (HCC), many issues remain surrounding the actual practice of screening. This review discusses how to diagnose and screen HCC and more importantly, how well we diagnose and screen for HCC. Improved survival and outcomes after HCC diagnosis depend upon accurate diagnosis of cirrhosis and the timeliness of screening. With all oral direct-acting antivirals now widely available for hepatitis C, there are increasing numbers of patients who may be cured but are still at risk of HCC. Some uncontrolled studies suggest that direct-acting antiviral therapy may even increase the risk of HCC. Before we discuss expansion of who should be screened, we need physicians to realize how poorly we screen those patients who are already recommended for screening by guidelines. (Hepatology Communications 2017;1:18-22).
虽然所有主要肝脏学会都有关于肝细胞癌（HCC）筛查和管理的指南，但围绕实际筛查实践仍存在许多问题。本综述讨论了如何诊断和筛查HCC，更重要的是，我们对HCC的诊断和筛查效果如何。HCC诊断后生存率和预后的改善取决于肝硬化的准确诊断和筛查的及时性。随着所有口服直接抗病毒药物现已广泛用于丙型肝炎治疗，可能治愈但仍有HCC风险的患者数量不断增加。一些非对照研究表明，直接抗病毒治疗甚至可能增加HCC风险。在我们讨论扩大筛查对象之前，我们需要医生认识到，对于那些已被指南推荐进行筛查的患者，我们的筛查工作做得有多差。（《肝脏病学通讯》2017年；1:18 - 22）
