Controversies in surveillance and early diagnosis of hepatocellular carcinoma.
The surveillance of hepatocellular carcinoma (HCC) is an established approach to detect early cancers in patients with defined risks. However, there are still varied controversies and issues to be addressed regarding the optimal surveillance methods and interval. Moreover, there are discrepancies in the opinion or practice of HCC surveillance between Eastern and Western countries. The Western strategy of ultrasound without a biomarker such as α-fetoprotein reflects the cost-effective utilization of limited resources. On the contrary, combined measurements of biomarkers in Eastern countries are based on the assumption that increased detection of early cancers could result in an overall survival benefit. To address this complicated issue, a prospective study comparing different surveillance tests might be required. More importantly, discovery of a novel biomarker with higher performance would be an alternative.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Do Young
DY
Kim
Jin Wook
JW
Kim
Ryoko
R
Kuromatsu
Sang Hoon
SH
Ahn
Takuji
T
Torimura
Morris
M
Sherman
D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000821:virology; D055088:Early Detection of Cancer / Q000379:methods*; D016174:Hepacivirus / Q000472:pathogenicity; D006509:Hepatitis B / Q000150:complications / Q000821:virology; D006526:Hepatitis C / Q000150:complications / Q000821:virology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000821:virology; D011159:Population Surveillance / Q000379:methods*; D018608:Ultrasonography, Doppler; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins