肝细胞癌:寻找最佳筛查检测方法
Hepatocellular Carcinoma: The Search for an Optimal Screening Test.
作者信息
Haj Ali Sara, Alqato Shahd I, Almansi Amjad M, Haj Ali Noor S, Amaireh Mohammad A
机构信息
Internal Medicine Department, Faculty of Medicine, Al-Balqa Applied University, Salt 19117, Jordan.
Internal Medicine Department, Arab Medical Center, Amman 11181, Jordan.
出版信息
Middle East J Dig Dis. 2025 Jan;17(1):31-39. doi: 10.34172/mejdd.2025.407. Epub 2025 Jan 31.
Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the third leading cause of cancer-related death, with a 5-year survival rate of 10%-12%. It usually develops in the setting of chronic liver disease (CLD), with chronic viral hepatitis, alcohol, and non-alcoholic fatty liver disease (NAFLD) being the most common risk factors. Some patients are at higher risk of developing hepatocellular cancer, so it is important to screen them regularly to diagnose the disease at an early stage and improve their chances for curative treatment. Six-monthly ultrasound with or without alpha-fetoprotein (AFP) is the currently recommended surveillance method. AFP has been used as a biomarker for liver cancer; however, it has low sensitivity and specificity, which necessitates the search for other, more accurate biomarkers. Promising biomarkers include lens culinaris agglutinin-reactive AFP, des-gamma-carboxy prothrombin, methylated DNA markers, plasma microRNA expression, circulating tumor DNA, and circulating tumor cells. In addition, combinations of biomarkers, like the GALAD score and the Doylestown algorithm, may help in the early detection of HCC. In this review, we summarize the screening tests for early detection of HCC that have been studied over the last decade.
肝细胞癌(HCC)是全球第六大常见癌症,也是癌症相关死亡的第三大主要原因,5年生存率为10%-12%。它通常在慢性肝病(CLD)的背景下发生,慢性病毒性肝炎、酒精和非酒精性脂肪性肝病(NAFLD)是最常见的危险因素。一些患者患肝细胞癌的风险较高,因此定期对他们进行筛查,以便在疾病早期进行诊断并提高治愈性治疗的机会非常重要。目前推荐的监测方法是每六个月进行一次超声检查,可联合或不联合甲胎蛋白(AFP)检测。AFP一直被用作肝癌的生物标志物;然而,它的敏感性和特异性较低,这就需要寻找其他更准确的生物标志物。有前景的生物标志物包括豆凝集素反应性AFP、脱γ-羧基凝血酶原、甲基化DNA标志物、血浆微小RNA表达、循环肿瘤DNA和循环肿瘤细胞。此外,生物标志物组合,如GALAD评分和多伊尔斯顿算法,可能有助于早期检测HCC。在这篇综述中,我们总结了过去十年中研究的用于早期检测HCC的筛查试验。
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J Clin Transl Hepatol. 2023-4-28