Hepatocellualar Carcinoma Serum Markers

Bertino, Gaetano; Ardiri, Annalisa; Malaguarnera, Michele; Malaguarnera, Giulia; Bertino, Nicoletta; Calvagno, Giuseppe Stefano

doi:10.1053/j.seminoncol.2012.05.001

Cited by 147 publications

(137 citation statements)

References 178 publications

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“…Several studies have concluded that the eradication of HCV infection slows the progression of the disease, improves the survival, and reduces the incidence of liver failure and the risk of developing liver cancer [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] . The understanding of the natural history of chronic hepatitis C and its long-term consequences is essential to enable appropriate decisions on treatment, but unfortunately the natural history of HCV infection is still the subject of much controversy.…”

Section: Natural History Of Chronic Hepatitis Cmentioning

confidence: 99%

Chronic hepatitis C: This and the new era of treatment

Bertino

Ardiri

Proiti

et al. 2016

WJH

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Over the last years it has started a real revolution in the treatment of chronic hepatitis C. This occurred for the availability of direct-acting antiviral agents that allow to reach sustained virologic response in approximately 90% of cases. In the near future further progress will be achieved with the use of pan-genotypic drugs with high efficacy but without side effects. Core tip: This review analyzes the current therapies for chronic hepatitis C and the future challenges of the research. So it tries to give an update on the research of hepatitis C virus (HCV) infection, providing a critical view of the emerging therapies and their impact on the future management of HCV infection. Since novel TOPIC HIGHLIGHT Chronic hepatitis C: This and the new era of treatment2016 Hepatitis C Virus: Global view treatments for HCV infection are highly efficacious but costly, priority should be given to patients with advanced hepatic fibrosis, which is a disease that cannot be deferred. INTRODUCTIONThe hepatitis C virus (HCV), identified in the 70s but cloned in 1989, is a single-stranded RNA virus belonging to the family Flaviviridae.HCV is the main cause of progressive liver diseases and a public health problem worldwide. It is estimated that approximately 150-180 million people in the world are living with chronic hepatitis [1,2] , 350 million of whom die each year from liver damage associated with the infection [3] . About 80% of people infected with HCV develop chronic hepatitis, of which 20%-40% will develop liver cirrhosis or hepatocellular carcinoma (HCC) 20-30 years after infection.As a consequence, chronic HCV infection is the major reason of liver transplantation in developed countries [4][5][6][7] . According to the Global Burden Disease Study in Europe, the death rate for viral hepatitis is significantly higher than that for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome; in particular in 2010, the number of deaths from viral hepatitis have been ten times bigger than that attributed to HIV. It is reasonable to think that this difference is due to the lack of effective therapies for HCV until a few years ago [8] .HCV is also one of the main causes of death [9] . The virus causes both liver damage and extra-hepatic manifestations, many of these syndromes are associated with the ability of HCV to replicate in peripheral blood mononuclear cells (PBMCs); an example is the mixed cryoglobulinemia, which is by far the most common extrahepatic disease closely connected with the infection.Recently it was shown that antiviral treatment is associated with improved renal and cardiovascular outcomes in patients with cryoglobulinemia [4,6,10,11] . Newly approved oral anti-HCV drugs are very safe and effective, but unfortunately their cost will force to choose a priority of treatment. The intent should therefore be to identify and treat patients with a higher risk of morbidity and mortality due to HCV.The availability of these new oral treatments can definitely heal patients and ...

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Section: Natural History Of Chronic Hepatitis Cmentioning

confidence: 99%

Chronic hepatitis C: This and the new era of treatment

Bertino

Ardiri

Proiti

et al. 2016

WJH

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“…(1) host-related risk factors: Older age, Asian ethnicity, male sex, alcohol intake and advanced liver disease [55][56][57] ; (2) viral risk factors: HBV genotype C, mutations of pre-S, enhancer-H, core promoter, HCV or hepatitis Delta virus infection and PC/BCP HBV variants [45,58] ; and (3) risk factors related to host-virus interaction: Cirrhosis, high HBV-DNA serum levels, prolonged HBeAg positivity, prolonged HBsAg positivity and high HBsAg serum levels [59][60][61][62] . Lastly, the HCC risk factors in chronic HBV infection are different and the pathogenesis is characterized by the combined action of different alterations involving genetic, epigenetic and immunological factors [63][64][65][66][67][68][69][70][71] (Figure 1).…”

Section: Development Of Hcc In Chronic Hbv Infectionmentioning

confidence: 99%

“…Despite the progress achieved in understanding the cancer process and the impact of this knowledge on treatment, primary prevention remains the most effective approach to reduce cancer mortality in both developed and developing countries for the near future [9,37,38,50,51,56,309] . …”

Section: Future Directionsmentioning

confidence: 99%

Hepatocellular carcinoma and the risk of occupational exposure

Rapisarda

Loreto

Malaguarnera

et al. 2016

WJH

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Hepatocellular carcinoma (HCC) is the most common type of liver cancer. The main risk factors for HCC are alcoholism, hepatitis B virus, hepatitis C virus, nonalcoholic steatohepatitis, obesity, type 2 diabetes, cirrhosis, aflatoxin, hemochromatosis, Wilson's disease and hemophilia. Occupational exposure to chemicals is another risk factor for HCC. Often the relationship between occupational risk and HCC is unclear and the reports are fragmented and inconsistent. This review aims to summarize the current knowledge regarding the association of infective and non-infective occupational risk exposure and HCC in order to encourage further research and draw attention to this global occupational public health problem. Core tip: Hepatocellular carcinoma (HCC) is the fifth most common human cancer. This review summarizes current knowledge regarding the occupational risk factors of HCC. In particular, we underline not only the infective but also non-infective occupational risk exposure, including chemical agents and toxic metabolites which are a major cause of liver damage.

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“…35 Combination of biomarkers can offer substantial advantages with respect to AFP alone. 36 In a nested case-control study, des-gamma-carboxy prothrombin and AFP had sensitivities of 74% and 61% for HCC at any stage, but these increased to 91% by using the 2 markers in combination. 37 The removal of AFP from the American Association for the Study of Liver Diseases guidelines has been still questioned.…”

Section: Tertiary Preventionmentioning

confidence: 98%

“…34 Serologic tumor bio markers include AFP, des-gamma-carboxy prot hrombin, the ratio of glycosylated AFP (L3 fraction) to total AFP, alpha-fucosidase, and glypican-3. 35,36 Alpha-fetoprotein is still the most widely tested biomarker for HCC despite its suboptimal performance for surveillance. 34 Serum levels of AFP can fluctuate along with exacerbation of underlying liver disease and can present in the normal range when HCC is at an early stage.…”

Section: Tertiary Preventionmentioning

confidence: 99%

Untitled

Etık

Suna²,

Boyacioglu³

2017

Exp Clin Transplant

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More than 600 000 people die from hepatocellular carcinoma each year. Worldwide, research on the disease needs to be intensified in both the medical and pharmaceutical fields, with a focus on providing help to geographic areas where resources are limited. Treatment approaches depend on the stage of the disease at diagnosis and on access to complex treatment regimens. However, advanced disease is not curable, and treating these patients is expensive and only marginally effective for increasing qualityadjusted life-years. Although the Milan criteria are often used to determine which patients will benefit from liver transplantation, many centers have their own criteria for patient selection. According to criteria developed by Başkent University in Ankara, Turkey, patients with hepatocellular carcinoma and a cirrhotic liver but without extrahepatic disease should be candidates for liver transplant when possible, and living-donor liver transplant should be considered as an alternative rescue therapy for many of these patients. Tumor size and number should not be the sole criteria for excluding liver transplant. Although significant vascular invasion and extrahepatic dissemination definitely indicate major tumor dissemination, until sensitive tests for measuring circulating tumor cells are developed, we continue to recommend liver transplant regardless of tumor size and number. Various locoregional therapies for hepatocellular carcinoma are used before transplant to prevent tumor progression and to decrease the risk of recurrence after transplant. In turn, response to locoregional therapy to decrease tumor stage in hepatocellular carcinoma may be an indicator of tumor behavior and may determine a patient's selection for liver transplant. The delivery of healthcare services for hepatocellular carcinoma could be improved by developing centers of excellence. Concentrating medical care in this way can lead to an increased level of expertise so that resections are performed by surgeons who understand liver disease and the limitations of these and other procedures.

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Hepatocellualar Carcinoma Serum Markers

Cited by 147 publications

References 178 publications

Chronic hepatitis C: This and the new era of treatment

Chronic hepatitis C: This and the new era of treatment

Hepatocellular carcinoma and the risk of occupational exposure

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