Rizikové faktory a surveillance hepatocelulárního karcinomu

Abstract

Hepatocellular carcinoma (HCC) is the second most frequent cause of cancer-related death globally. Approximately 90% of HCCs are associated with a known underlying etiology, most frequently liver cirrhosis owing to chronic hepatitis B and C. HCC surveillance is based on regular examination of patients in higher risk of HCC occurrence in order to decrease HCC-related mortality. The target population for HCC surveillance is represented by patients with liver cirrhosis, independently of its origin. Tests that can be used in HCC surveillance include serological tests and imaging examinations. The imaging test most widely used for surveillance is ultrasound (US), which has an acceptable diagnostic accuracy. Alpha-fetoprotein is the most widely used serological marker used in surveillance but due to its suboptimal performance in surveillance, it should not be used if US examination is available. In conclusion, US performed biannually can be seen nowadays as the most appropriate test to perform HCC surveillance.