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Article: Guide for diagnosis and treatment of hepatocellular carcinoma.

Attwa, Magdy Hamed / El-Etreby, Shahira Aly

2015 Volume 7, Issue 12, Page(s) 1632–1651

Abstract: Hepatocellular carcinoma (HCC) is ranked as the 5(th) common type of cancer worldwide and is ... on the different diagnostic modalities and treatment options of HCC. ... specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials ...

Abstract	Hepatocellular carcinoma (HCC) is ranked as the 5(th) common type of cancer worldwide and is considered as the 3(rd) common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosis is determined by several factors; tumour extension, alpha-fetoprotein (AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound (US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography (CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.
Language	English
Publishing date	2015-06-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2573703-X
ISSN	1948-5182
ISSN	1948-5182
DOI	10.4254/wjh.v7.i12.1632
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Article ; Online: Erratum: AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma.

Hepatology (Baltimore, Md.)

2023 Volume 78, Issue 6, Page(s) E105

Language	English
Publishing date	2023-10-16
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000621
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Article ; Online: AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma.

Singal, Amit G / Llovet, Josep M / Yarchoan, Mark / Mehta, Neil / Heimbach, Julie K / Dawson, Laura A / Jou, Janice H / Kulik, Laura M / Agopian, Vatche G / Marrero, Jorge A / Mendiratta-Lala, Mishal / Brown, Daniel B / Rilling, William S / Goyal, Lipika / Wei, Alice C / Taddei, Tamar H

Hepatology (Baltimore, Md.)

2023 Volume 78, Issue 6, Page(s) 1922–1965

MeSH term(s)	Humans ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/prevention & control ; Liver Neoplasms/diagnosis ; Liver Neoplasms/prevention & control ; Contrast Media ; Tomography, X-Ray Computed
Chemical Substances	Contrast Media
Language	English
Publishing date	2023-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000466
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Article ; Online: Acute hepatic porphyrias - a guide for Hepatologists.

Moghe, Akshata / McGuire, Brendan M / Levy, Cynthia

Hepatology (Baltimore, Md.)

2024

Abstract: ... of hepatocellular carcinoma. The AHPs are very treatable conditions, with excellent outcomes if diagnosed and treated early ... treatment will help reduce the burden of disease and prevent irreversible complications in patients with AHP. ... precursors, porphobilinogen (PBG) and/or aminolevulinic acid (ALA), in the blood. The diagnosis is often ...

Abstract	The acute hepatic porphyrias (AHPs) are a group of rare, inherited disorders of the heme biosynthesis pathway, usually manifesting with attacks of acute abdominal pain and other neurovisceral symptoms, with or without cutaneous manifestations. AHP are characterized by the accumulation of porphyrin precursors, porphobilinogen (PBG) and/or aminolevulinic acid (ALA), in the blood. The diagnosis is often missed or delayed due to both inadequate testing and the improper use of available laboratory tests. In this review, we describe the various clinical presentations of the four AHPs, elucidate the approach to diagnosis, and provide recommendations for immediate as well as long-term management. We also describe the different complications that can occur with long-standing AHP, including the development of hepatocellular carcinoma. The AHPs are very treatable conditions, with excellent outcomes if diagnosed and treated early. A high index of suspicion for the presence of these disorders along with accurate testing and timely treatment will help reduce the burden of disease and prevent irreversible complications in patients with AHP.
Language	English
Publishing date	2024-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000880
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Article ; Online: Hepatitis B core-related antigen: A novel and promising surrogate biomarker to guide anti-hepatitis B virus therapy.

Inoue, Takako / Watanabe, Takehisa / Tanaka, Yasuhito

Clinical and molecular hepatology

2023 Volume 29, Issue 4, Page(s) 851–868

Abstract: ... with reduction of the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B. Recently, a fully ... monitoring HBcrAg may be suitable for determining the therapeutic effectiveness of approved drugs and novel ... One is a fully-automated and highly sensitive measurement system; the other is a simple system ...

Abstract	The current requirement for biomarkers to detect hepatitis B virus (HBV) infection is polarized. One is a fully-automated and highly sensitive measurement system; the other is a simple system for point-of-care testing (POCT) in resource-limited areas. Hepatitis B core-related antigen (HBcrAg) reflects intrahepatic covalently closed circular DNA and serum HBV DNA. Even in patients with undetectable serum HBV DNA or HBsAg loss, HBcrAg may remain detectable. Decreased HBcrAg levels are associated with reduction of the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B. Recently, a fully-automated, novel high-sensitivity HBcrAg assay (iTACT-HBcrAg, cut-off value: 2.1 logIU/mL) has been developed. This attractive assay has been released in Japan very recently. iTACT-HBcrAg can be useful for monitoring HBV reactivation and prediction of HCC occurrence, as an alternative to HBV DNA. Moreover, monitoring HBcrAg may be suitable for determining the therapeutic effectiveness of approved drugs and novel drugs under development. Presently, international guidelines recommend anti-HBV prophylaxis for pregnant women with high viral loads to prevent mother-to-child transmission of HBV. However, >95% of HBV-infected individuals live in countries where HBV DNA quantification is not available. Worldwide elimination of HBV needs the scaling-up of examination and medication services in resource-limited areas. Based on this situation, a rapid and easy HBcrAg assay as a POCT is valuable. This review provides the latest information regarding the clinical use of a new surrogate marker, HBcrAg, in HBV management, based on iTACT-HBcrAg or POCT, and introduces novel agents targeting HBV RNA/protein.
MeSH term(s)	Pregnancy ; Female ; Humans ; Hepatitis B virus/genetics ; Hepatitis B Core Antigens ; Carcinoma, Hepatocellular ; DNA, Viral ; Liver Neoplasms/diagnosis ; Infectious Disease Transmission, Vertical ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/drug therapy ; Hepatitis B/diagnosis ; Hepatitis B/drug therapy ; Biomarkers ; Hepatitis B Surface Antigens
Chemical Substances	Hepatitis B Core Antigens ; DNA, Viral ; Biomarkers ; Hepatitis B Surface Antigens
Language	English
Publishing date	2023-03-09
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2672560-5
ISSN	2287-285X ; 2287-2728
ISSN (online)	2287-285X
ISSN	2287-2728
DOI	10.3350/cmh.2022.0434
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Article ; Online: Identification of chromosomal instability-associated genes as hepatocellular carcinoma progression-related biomarkers to guide clinical diagnosis, prognosis and therapy.

Hu, Yueyang / Tang, Chuanyu / Zhu, Wen / Ye, Hanjie / Lin, Yuxing / Wang, Ruixuan / Zhou, Tianjun / Wen, Sai / Yang, Jian / Fang, Chihua

Computers in biology and medicine

2022 Volume 148, Page(s) 105896

Abstract: Hepatocellular carcinoma (HCC) is a type of cancer characterized by high heterogeneity and ... of chromosomal instability-associated genes during the progression of HCC and their potential clinical diagnosis and ... prognostic value and provides promising new ideas for developing therapeutic strategies to improve ...

Abstract	Hepatocellular carcinoma (HCC) is a type of cancer characterized by high heterogeneity and a complex multistep progression process. Significantly-altered biomarkers for HCC need to be identified. Differentially expressed genes and weighted gene co-expression network analyses were used to identify progression-related biomarkers. LASSO-Cox regression and random forest algorithms were used to construct the progression-related prognosis (PRP) score. Three chromosomal instability-associated genes (KIF20A, TOP2A, and TTK) have been identified as progression-related biomarkers. The robustness of the PRP scores were validated using four independent cohorts. Immune status was observed using the single-sample gene set enrichment analysis (ssGSEA). Comprehensive analysis showed that the patients with high PRP score had wider genomic alterations, more malignant phenotypes, and were in a state of immunosuppression. The diagnostic models constructed via logistic regression based on the three genes showed satisfactory performances in distinguishing HCC from cirrhotic tissues or dysplastic nodules. The nomogram combining PRP scores with clinical factors had a better performance in predicting prognosis than the tumor node metastasis classification (TNM) system. We further confirmed that KIF20A, TOP2A, and TTK were highly expressed in HCC tissues than in cirrhotic tissues. Downregulation of all three genes aggravated chromosomal instabilities in HCC and suppressed HCC cells viability both in vitro and in vivo. Overall, our study highlights the important roles of chromosomal instability-associated genes during the progression of HCC and their potential clinical diagnosis and prognostic value and provides promising new ideas for developing therapeutic strategies to improve the outcomes of HCC patients.
MeSH term(s)	Biomarkers, Tumor ; Carcinoma, Hepatocellular ; Chromosomal Instability ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Cirrhosis ; Liver Neoplasms
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2022-07-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2022.105896
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Zs.A 653: Show issues

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Article ; Online: Economic Implications of Hepatocellular Carcinoma Surveillance and Treatment: A Guide for Clinicians.

Likhitsup, Alisa / Parikh, Neehar D

PharmacoEconomics

2019 Volume 38, Issue 1, Page(s) 5–24

Abstract: ... and associated costs. Treatment allocation depends on the stage of diagnosis ... effectiveness of surveillance of and treatments for HCC in the context of current treatment guidelines ... surveillance treatment modalities published between January 2000 and January 2019. The overall economic burden ...

Abstract	The incidence of hepatocellular carcinoma (HCC) is increasing worldwide, with significant morbidity and associated costs. Treatment allocation depends on the stage of diagnosis; however, resource utilization can be significant across all stages. We aimed to summarize the available data on the cost effectiveness of surveillance of and treatments for HCC in the context of current treatment guidelines. We performed a focused review of studies investigating the economic burden and cost effectiveness of HCC surveillance treatment modalities published between January 2000 and January 2019. The overall economic burden of HCC is increasing in the USA and in several countries worldwide due to its rising incidence and the proliferation of therapies. Liver transplantation is a cost-effective strategy for early-stage HCC treatment in selected patients. In settings where liver transplantation is not available or in patients awaiting transplant, ablative or locoregional therapies are cost effective with increases in quality-adjusted life-years. First-line therapy with sorafenib for advanced stage HCC is cost effective in the treatment of compensated cirrhosis. The cost effectiveness of recently approved systemic therapies for advanced HCC require further investigation. Existing studies have shown that guideline-recommended surveillance techniques and several available therapies for the treatment of HCC are cost effective; however, there are limitations in the literature, including reliance on suboptimal modeling with incomplete/simplified model structure or inadequate inputs. With increasing therapeutic options in patients with HCC, understanding their relative value is critical in designing HCC treatment algorithms.
MeSH term(s)	Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/economics ; Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/economics ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/therapy ; Cost-Benefit Analysis ; Early Detection of Cancer/economics ; Humans ; Liver Cirrhosis/diagnostic imaging ; Liver Cirrhosis/economics ; Liver Cirrhosis/therapy ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/economics ; Liver Neoplasms/mortality ; Liver Neoplasms/therapy ; Liver Transplantation/economics ; Models, Economic ; Practice Guidelines as Topic ; Quality-Adjusted Life Years ; Sorafenib/administration & dosage ; Sorafenib/economics ; Sorafenib/therapeutic use ; Ultrasonography/economics
Chemical Substances	Antineoplastic Agents ; Sorafenib (9ZOQ3TZI87)
Language	English
Publishing date	2019-09-05
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	1100273-6
ISSN	1179-2027 ; 1170-7690
ISSN (online)	1179-2027
ISSN	1170-7690
DOI	10.1007/s40273-019-00839-9
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Article ; Online: Programmed death ligand-1 (PD-L1) as a predictive marker for immunotherapy in solid tumours: a guide to immunohistochemistry implementation and interpretation.

Paver, Elizabeth C / Cooper, Wendy A / Colebatch, Andrew J / Ferguson, Peter M / Hill, Sean K / Lum, Trina / Shin, Joo-Shik / O'Toole, Sandra / Anderson, Lyndal / Scolyer, Richard A / Gupta, Ruta

Pathology

2020 Volume 53, Issue 2, Page(s) 141–156

Abstract: ... urothelial carcinoma, gastric and gastroesophageal carcinoma, colorectal carcinoma, hepatocellular carcinoma ... and endometrial carcinoma. The review aims to provide pathologists with a practical guide ... for non-small cell lung cancer and melanoma. The list of approved indications for treatment with PD-1/PD-L1 checkpoint inhibitors ...

Abstract	Immunotherapy with checkpoint inhibitors is well established as an effective treatment for non-small cell lung cancer and melanoma. The list of approved indications for treatment with PD-1/PD-L1 checkpoint inhibitors is growing rapidly as clinical trials continue to show their efficacy in patients with a wide range of solid tumours. Clinical trials have used a variety of PD-L1 immunohistochemical assays to evaluate PD-L1 expression on tumour cells, immune cells or both as a potential biomarker to predict response to immunotherapy. Requests to pathologists for PD-L1 testing to guide choice of therapy are rapidly becoming commonplace. Thus, pathologists need to be aware of the different PD-L1 assays, methods of evaluation in different tumour types and the impact of the results on therapeutic decisions. This review discusses the key practical issues relating to the implementation of PD-L1 testing for solid tumours in a pathology laboratory, including evidence for PD-L1 testing, different assay types, the potential interchangeability of PD-L1 antibody clones and staining platforms, scoring criteria for PD-L1, validation, quality assurance, and pitfalls in PD-L1 assessment. This review also explores PD-L1 IHC in solid tumours including non-small cell lung carcinoma, head and neck carcinoma, triple negative breast carcinoma, melanoma, renal cell carcinoma, urothelial carcinoma, gastric and gastroesophageal carcinoma, colorectal carcinoma, hepatocellular carcinoma, and endometrial carcinoma. The review aims to provide pathologists with a practical guide to the implementation and interpretation of PD-L1 testing by immunohistochemistry.
MeSH term(s)	B7-H1 Antigen/analysis ; Biomarkers, Tumor/analysis ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Carcinoma, Non-Small-Cell Lung/diagnosis ; Carcinoma, Non-Small-Cell Lung/pathology ; Carcinoma, Non-Small-Cell Lung/therapy ; Carcinoma, Renal Cell/diagnosis ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/therapy ; Carcinoma, Transitional Cell/diagnosis ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/therapy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Diagnostic Tests, Routine ; Endometrial Neoplasms/diagnosis ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/therapy ; Female ; Head and Neck Neoplasms/diagnosis ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/therapy ; Humans ; Immune Checkpoint Inhibitors/analysis ; Immunohistochemistry ; Immunotherapy ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/pathology ; Kidney Neoplasms/therapy ; Liver Neoplasms/diagnosis ; Liver Neoplasms/pathology ; Liver Neoplasms/therapy ; Male ; Melanoma/diagnosis ; Melanoma/pathology ; Melanoma/therapy ; Neoplasm Grading ; Neoplasms/diagnosis ; Neoplasms/pathology ; Neoplasms/therapy ; Prognosis ; Programmed Cell Death 1 Receptor/analysis ; Triple Negative Breast Neoplasms/diagnosis ; Triple Negative Breast Neoplasms/pathology ; Triple Negative Breast Neoplasms/therapy
Chemical Substances	B7-H1 Antigen ; Biomarkers, Tumor ; CD274 protein, human ; Immune Checkpoint Inhibitors ; Programmed Cell Death 1 Receptor
Language	English
Publishing date	2020-12-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2020.10.007
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Article ; Online: A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence.

Temple, Jonathan L / Cordero, Paul / Li, Jiawei / Nguyen, Vi / Oben, Jude A

International journal of molecular sciences

2016 Volume 17, Issue 6

Abstract: ... of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention. ... of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence ... the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and ...

Abstract	Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most prevalent form of chronic liver disease, affecting 10%-20% of the general paediatric population. Within the next 10 years it is expected to become the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and adolescence in the Western world. While our understanding of the pathophysiological mechanisms underlying this disease remains limited, it is thought to be the hepatic manifestation of more widespread metabolic dysfunction and is strongly associated with a number of metabolic risk factors, including insulin resistance, dyslipidaemia, cardiovascular disease and, most significantly, obesity. Despite this, "paediatric" NAFLD remains under-studied, under-recognised and, potentially, undermanaged. This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence of definitive radiological and histopathological diagnostic tests, maintenance of a high clinical suspicion by all members of the multidisciplinary team in primary and specialist care settings remains the most potent of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention.
MeSH term(s)	Adolescent ; Age Factors ; Carcinoma, Hepatocellular/etiology ; Child ; Disease Management ; Humans ; Liver Cirrhosis/etiology ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/etiology ; Non-alcoholic Fatty Liver Disease/therapy ; Risk Factors
Language	English
Publishing date	2016-06-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms17060947
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Article: Fatty liver disease--a practical guide for GPs.

Iser, David / Ryan, Marno

Australian family physician

2013 Volume 42, Issue 7, Page(s) 444–447

Abstract: ... Hepatocellular carcinoma has also been described in NASH without cirrhosis. Assessment and treatment of features ... to cirrhosis. Cirrhosis may be complicated by hepatocellular carcinoma or liver failure ... but weight loss remains the only effective treatment for NAFLD. ...

Abstract	Background: Non-alcoholic fatty liver disease (NAFLD), encompassing both simple steatosis and non-alcoholic steato-hepatitis (NASH), is the most common cause of liver disease in Australia. Non-alcoholic fatty liver disease needs to be considered in the context of the metabolic syndrome, as cardiovascular disease will account for much of the mortality associated with NAFLD. Objective: To provide an approach to the identification of NAFLD in general practice, the distinction between simple steatosis and NASH, and the management of these two conditions. Discussion: Non-alcoholic steato-hepatitis is more common in the presence of diabetes, obesity, older age and increased inflammation, and is more likely to progress to cirrhosis. Cirrhosis may be complicated by hepatocellular carcinoma or liver failure. Hepatocellular carcinoma has also been described in NASH without cirrhosis. Assessment and treatment of features of the metabolic syndrome may reduce associated cardiovascular mortality. Numerous agents have been evaluated, but weight loss remains the only effective treatment for NAFLD.
MeSH term(s)	Australia ; Fatty Liver/diagnosis ; Fatty Liver/therapy ; General Practice ; General Practitioners ; Humans ; Liver/pathology ; Non-alcoholic Fatty Liver Disease
Language	English
Publishing date	2013-07
Publishing country	Australia
Document type	Journal Article ; Practice Guideline
ZDB-ID	423718-3
ISSN	0300-8495
ISSN	0300-8495
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