Hepatocellular carcinoma: Comparison of two different periods at the same center

Soresi, Maurizio; Spada, Emanuele La; Giannitrapani, Lydia; Campagna, Elisa; Gesaro, Valeria Di; Granà, W.; Sandonato, Luigi; Brancatelli, Giuseppe; Rotolo, Giuseppe; Affronti, Andrea; Montalto, Giuseppe

doi:10.1016/j.ejim.2009.12.011

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…In the fi rst period chronic viral hepatitis was the major risk factor for developing HCC, alcoholic cirrhosis became the predominant etiology in period 2. Th is is in line with data from other regions in Europe like Southern Germany, Portugal, and France [20,31,32], but is diff erent from many other countries [3,33,34], where the majority of cases are still attributed to chronic HCV infection.…”

Section: Discussionsupporting

confidence: 84%

Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

Hucke

Sieghart

Schöniger–Hekele

et al. 2011

Wien Klin Wochenschr

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Section: Discussionsupporting

confidence: 84%

Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

Hucke

Sieghart

Schöniger–Hekele

et al. 2011

Wien Klin Wochenschr

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“…Early diagnosis is not easy, due to the limited sensitivity of US, not exceeding 60% in very early HCC [6,7], and to the pattern of tumor spread, which can sometimes be multinodular or infiltrating [8,9]. The positive and negative predictive values are consistent with data reported in the literature when, as in our study, the gold standard consists of radiological investigations such as CT and MR.…”

Section: Discussionsupporting

confidence: 81%

“…Their main goal is to diagnose the so-called very early HCC, that is, a neoplastic nodule measuring <2 cm [2]. This diagnosis is not always easy, both due to the relatively low sensitivity of the tool, which in very early HCC does not exceed 60% [6,7], and due to the pattern of presentation at onset, which is sometimes multinodular or infiltrative [8,9]. Therefore, other indicators to select patients who may have a higher risk of progression in HCC are necessary [10].…”

Section: Introductionmentioning

confidence: 99%

644 Surveillance Program for Diagnosis of HCC in Liver Cirrhosis: Role of Ultrasound Echopatterns

Soresi¹,

Giannitrapani²,

Campagna³

et al. 2013

Journal of Hepatology

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International guidelines suggest ultrasound surveillance for hepatocellular carcinoma (HCC) early diagnosis in liver cirrhosis (LC) patients, but 40% of nodules <2 cm escape detection. We investigated the existence of an ultrasound pattern indicating a higher risk of developing HCC in patients under surveillance. 359 patients with LC (Child-Pugh A-B8) underwent ultrasound screening (median follow-up 54 months, range 12-90 months), liver function tests, alpha-fetoprotein assay, and portal hypertension evaluation. Echo patterns were homogeneous, bright liver, coarse, coarse small nodular pattern, and coarse large nodular pattern. During follow-up 13.9% developed HCC. At multivariate analysis using Cox's model alpha-fetoprotein, coarse large nodular pattern, portal hypertension, and age were independent predictors of HCC development. Kaplan-Meier estimates of HCC cumulative risk in relation to the baseline echo patterns showed risk of 75% in coarse large nodular pattern patients, 23% coarse small nodular pattern, 21% coarse pattern, 0% homogeneous, and bright liver echo patterns (log-rank test = 23.6, < 0.001). Coarse large nodular pattern indicates a major risk factor for HCC as 40.7% of patients with this pattern developed HCC. Homogeneous and bright liver echo patterns and the absence of portal hypertension were not related to HCC. This observation could raise the question of possibly modifying the follow-up timing in this subset of patients.

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“…The aetiology of the liver disease was determined using historical, clinical, laboratory, imaging and histological information. The diagnosis of cirrhosis and HCC were made based on previously reported criteria [46], and international guidelines [47]. In the majority of instances the diagnosis of cirrhosis was based on historical, clinical, laboratory and radiological variables; histological confirmation was available in a minority from liver biopsy material obtained via the percutaneous route (Table 2).…”

Section: Methodsmentioning

confidence: 99%

The association of variants in PNPLA3 and GRP78 and the risk of developing hepatocellular carcinoma in an Italian population

et al. 2016

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Hepatocellular carcinoma (HCC) has one of the worst prognoses amongst all malignancies. It commonly arises in patients with established liver disease and the diagnosis often occurs at an advanced stage. Genetic variations, such as single nucleotide polymorphisms (SNPs), may alter disease risk and thus may have use as predictive markers of disease outcome. The aims of this study were (i) to assess the association of two SNPs, rs430397 in GRP78 and rs738409 in PNPLA3 with the risk of developing HCC in a Sicilian association cohort and, (ii) to use a machine learning technique to establish a predictive combinatorial phenotypic model for HCC including rs430397 and rs738409 genotypes and clinical and laboratory attributes. The controls comprised of 304 healthy subjects while the cases comprised of 170 HCC patients the majority of whom had hepatitis C (HCV)–related cirrhosis. Significant associations were identified between the risk of developing HCC and both rs430397 (p=0.0095) and rs738409 (p=0.0063). The association between rs738409 and HCC was significantly stronger in the HCV positive cases. In the best prediction model, represented graphically by a decision tree with an acceptable misclassification rate of 17.0%, the A/A and G/A genotypes of the rs430397 variant were fixed and combined with the three rs738409 genotypes; the attributes were age, sex and alcohol. These results demonstrate significant associations between both rs430397 and rs738409 and HCC development in a Sicilian cohort. The combinatorial predictive model developed to include these genetic variants may, if validated in independent cohorts, allow for earlier diagnosis of HCC.

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Hepatocellular carcinoma: Comparison of two different periods at the same center

Cited by 13 publications

References 21 publications

Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

Clinical characteristics of patients with hepatocellular carcinoma in Austria – is there a need for a structured screening program?

644 Surveillance Program for Diagnosis of HCC in Liver Cirrhosis: Role of Ultrasound Echopatterns

The association of variants in PNPLA3 and GRP78 and the risk of developing hepatocellular carcinoma in an Italian population

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