1
|
Akkari I, Jaziri H. Monitoring of hepatocellular carcinoma. World J Gastroenterol 2024; 30:991-993. [PMID: 38516232 PMCID: PMC10950649 DOI: 10.3748/wjg.v30.i8.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/12/2023] [Accepted: 02/01/2024] [Indexed: 02/26/2024] Open
Abstract
Screening for hepatocellular carcinoma in patients at risk is an evidence-based approach; however, adherence to the monitoring protocol recommended by international guidelines is difficult. Hence, there is a need to use the best scr-eening options and refine the selection of patients at risk in the future.
Collapse
Affiliation(s)
- Imen Akkari
- Department of Gastroenterology, University Hospital of Hached, University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
| | - Hanen Jaziri
- Department of Gastroenterology, University Hospital of Sahloul, University of Sousse, Faculty of Medicine of Sousse, Sousse 4054, Tunisia
| |
Collapse
|
2
|
You H, Wang F, Li T, Xu X, Sun Y, Nan Y, Wang G, Hou J, Duan Z, Wei L, Jia J, Zhuang H. Guidelines for the Prevention and Treatment of Chronic Hepatitis B (version 2022). J Clin Transl Hepatol 2023; 11:1425-1442. [PMID: 37719965 PMCID: PMC10500285 DOI: 10.14218/jcth.2023.00320] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Abstract
To facilitate the achieving of the goal of "eliminating viral hepatitis as a major public health threat by 2030" set by the World Health Organization, the Chinese Society of Hepatology together with the Chinese Society of Infectious Diseases (both are branches of the Chinese Medical Association) organized a panel of experts and updated the guidelines for prevention and treatment of chronic hepatitis B in China (version 2022). With the support of available evidence, this revision of the guidelines focuses on active prevention, large scale testing, and expansion of therapeutic indication of chronic hepatitis B with the aim of reducing the hepatitis B related disease burden.
Collapse
Affiliation(s)
- Hong You
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fusheng Wang
- The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Taisheng Li
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyuan Xu
- Peking University First Hospital, Beijing, China
| | - Yameng Sun
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuemin Nan
- Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | | | - Jinlin Hou
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhongping Duan
- Beijing You-An Hospital, Capital Medical University, Beijing, China
| | - Lai Wei
- Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Jidong Jia
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui Zhuang
- Peking University Health Science Center, Beijing, China
| | - Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
- The Fifth Medical Center of PLA General Hospital, Beijing, China
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Peking University First Hospital, Beijing, China
- Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Beijing You-An Hospital, Capital Medical University, Beijing, China
- Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
- Peking University Health Science Center, Beijing, China
| |
Collapse
|
3
|
Qiu YJ, Cheng J, Zuo D, Zhang Q, Tian XF, Lu XY, Chen S, Dong Y, Wang WP. Non-invasive evaluation of vascular architecture of focal liver lesions by micro vascular imaging. Clin Hemorheol Microcirc 2023:CH221682. [PMID: 36683501 DOI: 10.3233/ch-221682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To explore the value of vascular architecture detected by micro vascular imaging (MVI) in preoperative diagnosis of focal liver lesions (FLLs). METHODS In this retrospective study, patients with surgery and histopathologically proved or radiologically confirmed FLLs were included. Vascular architecture of FLLs were acquired by color Doppler flow imaging (CDFI) and MVI on LOGIQ™ E20 ultrasound machine (C1-6 convex array probes). Alder semiquantitative analysis (grade 0-3) and morphologic features of blood vessels (pattern a-f) were used to assess the blood flow within the FLLs. Interobserver agreement for evaluating blood flow of FLLs was analyzed. Using Adler's grading or morphologic patterns as diagnostic criteria for malignant FLLs, the diagnostic efficiency was analyzed and compared. RESULTS From October 2021 and February 2022, 50 patients diagnosed with 40 malignant FLLs and 10 benign FLLs were finally included. The Kappa value within two observers for evaluating the blood flow of FLLs was 0.78 for MVI and 0.55 for CDFI. According to Alder semiquantitative analysis, more high-level blood flow signals (grade 2-3) were detected by MVI than CDFI (P < 0.05). Based on high-level blood flow signals (grade 2-3) and hypervascular supply patterns (pattern e and f), the diagnostic accuracy for malignant FLLs were 76% and 68% for MVI, 56% and 38% for CDFI, respectively. CONCLUSION MVI is superior to CDFI in evaluating vascular architecture of FLLs. The high-level flow signals and hypervascular pattern detected by MVI have a useful and complementary value in preoperative non-invasive identification of malignant FLLs.
Collapse
Affiliation(s)
- Yi-Jie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dan Zuo
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiu-Yun Lu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sheng Chen
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
4
|
Wang G, Duan Z. Guidelines for Prevention and Treatment of Chronic Hepatitis B. J Clin Transl Hepatol 2021; 9:769-791. [PMID: 34722192 PMCID: PMC8516840 DOI: 10.14218/jcth.2021.00209] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/20/2021] [Accepted: 08/03/2021] [Indexed: 12/12/2022] Open
Abstract
To achieve the goal of the World Health Organization to eliminate viral hepatitis as a major public health threat by 2030, the Chinese Society of Infectious Diseases and the Chinese Society of Hepatology convened an expert panel in 2019 to update the guidelines for the prevention and treatment of chronic hepatitis B (CHB). The current guidelines cover recent advances in basic, clinical, and preventive studies of CHB infection and consider the actual situation in China. These guidelines are intended to provide support for the prevention, diagnosis, and treatment of CHB.
Collapse
Affiliation(s)
- Guiqiang Wang
- Center for Liver Diseases, Department of Infectious Diseases, Peking University First Hospital; Department of Infectious and Liver Diseases, Peking University International Hospital, Beijing, China
| | - Zhongping Duan
- Center for Difficult and Complicated Liver Diseases and Artificial Liver, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
An JY, Peña MA, Cunha GM, Booker MT, Taouli B, Yokoo T, Sirlin CB, Fowler KJ. Abbreviated MRI for Hepatocellular Carcinoma Screening and Surveillance. Radiographics 2020; 40:1916-1931. [PMID: 33136476 PMCID: PMC7714535 DOI: 10.1148/rg.2020200104] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/10/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
To detect potentially curable hepatocellular carcinoma (HCC), clinical practice guidelines recommend semiannual surveillance US of the liver in adult patients at risk for developing this malignancy, such as those with cirrhosis and some patients with chronic hepatitis B infection. However, cirrhosis and a large body habitus, both of which are increasingly prevalent in the United States and the rest of the world, may impair US visualization of liver lesions and reduce the sensitivity of surveillance with this modality. The low sensitivity of US for detection of early-stage HCC contributes to delayed diagnosis and increased mortality. Abbreviated MRI, a shortened MRI protocol tailored for early-stage detection of HCC, has been proposed as an alternative surveillance option that provides high sensitivity and specificity. Abbreviated MRI protocols include fewer sequences than a complete multiphase MRI examination and are specifically designed to identify small potentially curable HCCs that may be missed at US. Three abbreviated MRI strategies have been studied: (a) nonenhanced, (b) dynamic contrast material-enhanced, and (c) hepatobiliary phase contrast-enhanced abbreviated MRI. Retrospective studies have shown that simulated abbreviated MRI provides high sensitivity and specificity for early-stage HCC, mostly in nonsurveillance cohorts. If it is supported by scientific evidence in surveillance populations, adoption of abbreviated MRI could advance clinical practice by increasing early detection of HCC, allowing effective treatment and potentially prolonging life in the growing number of individuals with this cancer. Online supplemental material is available for this article. ©RSNA, 2020.
Collapse
Affiliation(s)
| | | | - Guilherme M. Cunha
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| | - Michael T. Booker
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| | - Bachir Taouli
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| | - Takeshi Yokoo
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| | - Claude B. Sirlin
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| | - Kathryn J. Fowler
- From the Liver Imaging Group, Department of Radiology, University of California San Diego, 9500 Gilman Dr, MC 0888, San Diego, CA 92093 (J.Y.A., G.M.C., M.T.B., C.B.S., K.J.F.); School of Medicine, Tufts University, Boston, Mass (M.A.P.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (B.T.); and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY (T.Y.)
| |
Collapse
|
6
|
Fang M, Yao M, Yang J, Zheng WJ, Wang L, Yao DF. Abnormal CD44 activation of hepatocytes with nonalcoholic fatty accumulation in rat hepatocarcinogenesis. World J Gastrointest Oncol 2020; 12:66-76. [PMID: 31966914 PMCID: PMC6960074 DOI: 10.4251/wjgo.v12.i1.66] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/26/2019] [Accepted: 10/02/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Prevalence of nonalcoholic fatty liver disease (NAFLD) is rapidly increasing, and NAFLD has become one of the most common chronic liver diseases worldwide. With abnormal CD44 activation, the severe form of NAFLD can progress to liver cirrhosis and hepatocellular carcinoma (HCC). Thus, the molecular mechanism of CD44 in NAFLD needs to be identified.
AIM To investigate the relationship between CD44 activation and malignant transformation of rat hepatocytes under nonalcoholic lipid accumulation.
METHODS Sprague-Dawley rats were fed a high-fat (HF) for 12 wk to entice NAFLD and then with HF plus 2-fluorenylacetamide (0.05%) to induce HCC. Rats were sacrificed every 2 wk, and subsequently divided into the groups based on liver pathological examination (hematoxylin and eosin staining): NAFLD, denaturation, precancerosis, HCC, and control. Liver CD44 mRNA was detected by OneArray. Liver fat as assessed by Oil red O staining or CD44 by immunohistochemical assay was compared with their integral optic density. Serum CD44, alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol, and AFP levels were quantitatively tested.
RESULTS Elevated CD44 was first reported in hepatocarcinogenesis, with increasing expression from NAFLD to HCC at the protein or mRNA level. The CD44 integral optic density values were significantly different between the control group and the NAFLD (t = 25.433, P < 0.001), denaturation (t = 48.822, P < 0.001), precancerosis (t = 27.751, P < 0.001), and HCC (t = 16.239, P < 0.001) groups, respectively. Hepatic CD44 can be secreted into the blood, and serum CD44 levels in HCC or precancerous rats were significantly higher (P < 0.001) than those in any of the other rats. Positive correlations were found between liver CD44 and CD44 mRNA (rs = 0.373, P = 0.043) and serum CD44 (rs = 0.541, P = 0.002) and between liver CD44 mRNA and serum CD44 (rs = 0.507, P = 0.004). Moreover, significant correlations were found between liver CD44 and liver AFP (rs = 0.572, P = 0.001), between serum CD44 and serum AFP (rs = 0.608, P < 0.001), and between CD44 mRNA and AFP mRNA (rs = 0.370, P = 0.044).
CONCLUSION The data suggested that increasing CD44 expression is associated with the malignant transformation of hepatocytes in NAFLD.
Collapse
Affiliation(s)
- Miao Fang
- Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Min Yao
- Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Jie Yang
- Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Wen-Jie Zheng
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Li Wang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Deng-Fu Yao
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| |
Collapse
|
7
|
Li J, Wang J, Yu S, Yuan G, He S. Letter to the Editor: Hepatocellular Carcinoma Surveillance in High-Risk Patients With Cirrhosis: Contrast-Enhanced Ultrasound May Be a Choice. Hepatology 2020; 71:392. [PMID: 31222762 DOI: 10.1002/hep.30819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Jiangfa Li
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jiming Wang
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shuiping Yu
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guandou Yuan
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Songqing He
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| |
Collapse
|