An Jihyun
Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Korean J Gastroenterol. 2021 Nov 25;78(5):255-260. doi: 10.4166/kjg.2021.142.
Detection of hepatocellular carcinoma (HCC) at an early stage enables patients to receive curative treatment with survival gains. Current international liver society guidelines recommend the enrollment of patients at high risk for HCC in surveillance programs. In Korea, surveillance for HCC advocated for patients with chronic hepatitis B, chronic hepatitis C, and liver cirrhosis. The established surveillance tool for HCC is liver ultrasonography plus serum alpha-fetoprotein measurement every 6 months. However, there would be obstacles to the improvement of efficacy and cost-effectiveness of the HCC surveillance test. Assessing who is at risk of developing HCC remains incompletely validated. Also, which surveillance tools to use according to patients' characteristics are controversial. The present paper reviews the latest knowledge regarding the strategies and cost-effectiveness of HCC surveillance.
早期发现肝细胞癌(HCC)可使患者接受治愈性治疗并提高生存率。当前国际肝脏学会指南建议将HCC高危患者纳入监测项目。在韩国,提倡对慢性乙型肝炎、慢性丙型肝炎和肝硬化患者进行HCC监测。已确立的HCC监测工具是每6个月进行一次肝脏超声检查加血清甲胎蛋白测量。然而,提高HCC监测检测的有效性和成本效益存在障碍。评估谁有患HCC的风险仍未得到充分验证。此外,根据患者特征使用哪种监测工具也存在争议。本文综述了有关HCC监测策略和成本效益的最新知识。