Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma

Tanaka, Sachiko; Kitamura, Tsugio; Nakanishi, K.; Okuda, Shujiro; Yamazaki, Hideo; Hiyama, Tomohiko; Fujimoto, Isaburo

doi:10.1002/1097-0142(19901115)66:10<2210::aid-cncr2820661028>3.0.co;2-7

Cited by 69 publications

(37 citation statements)

References 7 publications

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“…23,28,35,36,40,42 This did not translate into a comparable resection rate. In the majority of studies, the overall surgical resection rate varied from 29 to 54%.…”

Section: Surveillance Should Reduce Mortality From the Diseasementioning

confidence: 98%

“…To overcome this problem, surveillance has been extended to include patients with noncirrhotic chronic viral hepatitis as well as those with overt cirrhosis. The overall reported annual detection rate of HCC in surveillance studies, which included individuals with chronic hepatitis in addition to cirrhosis, is 0.8% to 4.1% [34][35][36][37][38][39][40] (Table 1).…”

Section: The Target Population Must Be Easily Identifiablementioning

confidence: 99%

“…In the majority of studies, the overall surgical resection rate varied from 29 to 54%. 22,[25][26][27][35][36][37]40,42 Failure to undertake hepatic resection was due mainly to age, patient wishes, cirrhosis, and impaired synthetic function or a poor general medical condition. 34,42 The preference for hepatic resection rather than liver transplantation in all the studies was not discussed.…”

Section: Surveillance Should Reduce Mortality From the Diseasementioning

confidence: 99%

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Screening for hepatocellular carcinoma

1998

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“…23,28,35,36,40,42 This did not translate into a comparable resection rate. In the majority of studies, the overall surgical resection rate varied from 29 to 54%.…”

Section: Surveillance Should Reduce Mortality From the Diseasementioning

confidence: 98%

Section: The Target Population Must Be Easily Identifiablementioning

confidence: 99%

Section: Surveillance Should Reduce Mortality From the Diseasementioning

confidence: 99%

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Screening for hepatocellular carcinoma

1998

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“…Extracting data regarding US from clinic-based studies, the sensitivity for small HCC ranged from 68% to 87% and false-positive rate from 28% to 82%. 122,123,133,134,143 Regenerating nodules, seen in patients with cirrhosis, are the most common reason for false-positive results. US is considerably more expensive than AFP, and, in most developed countries, requires a radiologist.…”

Section: Initial Evaluationmentioning

confidence: 99%

Chronic hepatitis B

2001

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PREAMBLEThese guidelines have been written to assist physicians and other health care providers in the recognition, diagnosis, and management of patients chronically infected with the hepatitis B virus (HBV). They are intended to suggest preferable approaches to the clinical management of chronic hepatitis B. The recommendations are flexible and are not intended as the only acceptable approach to management and treatment. As the appropriate course of treatment will vary in light of the relevant facts and circumstances surrounding each individual patient with chronic hepatitis B, guidelines are not intended to define the applicable standard of medical care and may be updated periodically as new information becomes available.These guidelines were developed under the auspices of, and approved by, the Practice Guidelines Committee of the American Association for the Study of Liver Diseases. They should be taken as guidelines and not "standards of care." Data used to support the recommendations made were obtained by a literature search of peer-reviewed articles concerning the natural history, diagnosis, and treatment of chronic hepatitis B. In addition, the proceedings of a recent National Institutes of Health workshop on the "Management of Hepatitis B" were considered in the development of these guidelines. 1 The strength of each recommendation is categorized based on the quality of evidence in the literature according to the rating system indicated in Table 1. 2

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“…Many CLD patients are, therefore, followed up periodically using ultrasonography (US) and serum a-fetoprotein (AFP) measurements to detect HCC at an early stage (Tanaka et al, 1990). Evaluation of the risk factors for HCC in CLD patients is imperative.…”

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confidence: 99%

Past exposure to hepatitis B virus as a risk factor for hepatocellular carcinoma in patients with chronic liver disease

Okada

Sato²,

Okusaka

et al. 1998

Br J Cancer

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Summary The aim of the study was to determine whether past exposure to hepatitis B virus (HBV) influences the risk of the development of hepatocellular carcinoma (HCC) in Japanese patients with chronic liver disease (CLD). We conducted a hospital-based case-control study of 141 HCC patients with CLD and 151 controls with CLD but without HCC. Past exposure to HBV was assessed by antibody to hepatitis B core antigen (anti-HBc) positivity. Ninety-two patients (65%) with HCC were anti-HBc positive compared with 65 patients (43%) with CLD alone (P < 0.01). A multivariate analysis using logistic regression modelling revealed that anti-HBc positivity significantly increased the rsk of the development of HCC [odds ratio (OR) 2.0, P= 0.01]. In the anti-HBc-positive patients, a significantly increased risk of HCC was seen among the patients positive for anti-HBc alone (OR, 2.6; P < 0.01). However, a significant OR was not obtained among the patients with a transient HBV infection implied by positivity for both antibody to hepatitis B surface antigen and anti-HBc (OR, 1.5; P = 0.48). These results indicate that past exposure to HBV is a risk factor for HCC in Japanese CLD patients, especially when they have no serological evidence of immunity to HBV.Keywords: hepatocellular carcinoma; chronic liver disease; hepatitis B virus; hepatitis C virus; case-control study In Japan, the vast majority of patients with hepatocellular carcinoma (HCC) have chronic liver disease (CLD) such as chronic hepatitis and liver cirrhosis, and CLD patients frequently develop HCC during the follow-up period; patients with CLD are at increased risk of developing HCC (Ikeda et al, 1993;Tsukuma et al, 1993). Many CLD patients are, therefore, followed up periodically using ultrasonography (US) and serum a-fetoprotein (AFP) measurements to detect HCC at an early stage (Tanaka et al, 1990). Evaluation of the risk factors for HCC in CLD patients is imperative. Identification of the individuals who are at higher risk of HCC would contribute to the early diagnosis of this disease and to effective implementation of strategies for chemoprevention.Numerous epidemiological and biological studies have indicated that a chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) plays an important role in hepatocarcinogenesis (Bruix et al, 1989;Saito et al, 1990;Kim et al, 1991). As for HBV, serum hepatitis B surface antigen (HBsAg) positivity, which indicates a chronic HBV carrier state, is a well-established risk factor for HCC (Beasley et al, 1981;Chen et al, 1991). However, only a few reports have addressed the relationship between past exposure to HBV and HCC and, as yet, no definite conclusion has been established (Chiba et al, 1996;Yu et al, 1997).This hospital-based case-control study was conducted to evaluate whether past exposure to HBV, which was assessed by antibody to hepatitis B core antigen (anti-HBc) positivity, influenced the risk of developing HCC in Japanese CLD patients. Study populationThe HCC patient group comprised 141 co...

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Effectiveness of periodic checkup by ultrasonography for the early diagnosis of hepatocellular carcinoma

Cited by 69 publications

References 7 publications

Screening for hepatocellular carcinoma

Screening for hepatocellular carcinoma

Chronic hepatitis B

Past exposure to hepatitis B virus as a risk factor for hepatocellular carcinoma in patients with chronic liver disease

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