肝癌风险，检测：近期有8例报道

StephenW

Liver cancer risks, detection: 8 recent reports
July 16, 2018

Patients with liver disease such as viral hepatitis and nonalcoholic fatty liver disease with cirrhosis are at increased risk for progression to hepatocellular carcinoma, which can also lead to extrahepatic cancer. Researchers have recently published new data on factors that improve early detection and diagnosis, as well as defining risks prior to HCC and during treatment.

Healio presents the following recent reports that include studies on ethnic differences in liver cancer detection, improved diagnosis with bi-annual screening, and innovative noninvasive testing solutions.

Ethnic differences determine liver cancer detection, outcomes

Researchers determined racial and ethnic differences that correlated with early detection of hepatocellular carcinoma and receipt of curative treatment, which could be used as intervention targets to improve patient outcomes.

“As with most malignancies, HCC tumor burden at diagnosis impacts both prognosis and treatment decisions,” Nicole E. Rich, MD, from the University of Texas Southwestern Medical Center, and colleagues wrote. “Understanding and quantifying potential differences is the first step to identify intervention targets and inform strategies to reduce existing disparities. Read more

Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more

Pediatric liver cancer may lead to brain metastases

Fibrolamellar hepatocellular carcinoma, a rare childhood liver cancer, metastasized to the brain, prompting researchers to recommend surveillance neuroimaging for patients with advanced disease, according to published findings.

“Current treatment for fibrolamellar hepatocellular carcinoma focuses on gross total resection, as systemic therapy remains unstandardized,” Sanford M. Simon, PhD, professor at the Laboratory of Cellular Biophysics at The Rockefeller University, and colleagues wrote. “However, fibrolamellar hepatocellular carcinoma is frequently diagnosed at an advanced stage, and the majority relapse within 1 year despite resection. ... Reports of two patients with brain metastasis exist in the literature but neither provides neuroimaging, pathologic or molecular analysis of the lesions.”

Plasma assay of methylated DNA markers detects liver cancer

In this exclusive video perspective from Digestive Disease Week 2018, John B. Kisiel, MD, a gastroenterologist from the Mayo Clinic in Rochester, Minn., shares results of a study in which plasma assay of methylated DNA markers detected hepatocellular carcinoma across all stages.

“These are markers we discovered as part of a larger set in an experiment that sequenced DNA extracted from frozen tissue specimens from patients at Mayo Clinic,” Kisiel told Healio Gastroenterology and Liver Disease. “The aim of the present study was to validate these markers in a larger cohort that included a spectrum of stages of disease, including early-stage patients who would be potentially curable.” Watch here

Exact Sciences expands noninvasive cancer testing in the GI space

In this exclusive industry perspective from Digestive Disease Week 2018, Kevin Conroy, CEO of Exact Sciences, discusses the company’s noninvasive Cologuard colon cancer test and recent data on a new noninvasive test for the detection of liver cancer.

“Exact Sciences’ mission is to help play a role in the eradication of colon cancer,” Conroy told Healio Gastroenterology and Liver Disease. “We developed Cologuard, which is a noninvasive stool DNA test that is the first and only stool DNA test approved by the FDA. It’s been used to screen over 1.1 million people in the U.S., and over 110,000 physicians use Cologuard.” Watch here

Stivarga improves HCC outcomes in cases of progression during Nexavar therapy

Stivarga therapy provided clinical benefit to patients with hepatocellular carcinoma and had similar adverse event rates regardless of the last Nexavar dose or time-to-progression on prior Nexavar therapy, according to a recently published study.

Richard S. Finn, MD, from the David Geffen School of Medicine at the University of California Los Angeles, and colleagues conducted a retrospective analysis of the RESOURCE trial — the results of which showed Stivarga (regorafenib, Bayer) significantly improved overall survival in patients whose HCC progressed during Nexavar (sorafenib, Bayer) therapy — to verify the outcomes of sequential treatment with sorafenib followed by regorafenib. Read more

Abstinence does not reduce HCC risk in alcoholic-related cirrhosis

Alcohol abstinence did not reduce the risk for hepatocellular carcinoma among patients with Child-Pugh class A or B alcohol-related cirrhosis, according to a presentation at the International Liver Congress 2018.

“Our goal was to investigate if abstinence reduces HCC risk in a series of patients with alcoholic liver cirrhosis who were included in an HCC surveillance program,” Andrés Castano-Garcia, MD, PhD, from the Hospital Universitario Central de Asturias in Spain, said in his presentation. “Abstinence was defined as the absence of any alcohol consumption from inclusion and established based on interviews with patients.” Read more

Novel score predicts liver cancer risk during HBV antiviral therapy

Researchers developed a predictive risk score for the development hepatocellular carcinoma during oral antiviral therapy in patients with chronic hepatitis B, according to recently published data.

“The score requires simple information that is readily available in all treated patients,” Yao-Chun Hsu, MD, from the Fu-Jen Catholic University, Taiwan, and colleagues wrote. “By stratifying patients at different risks of HCC, the easily applicable score may inform the clinical practice and healthcare policy in the era of antiviral treatment for [chronic HBV].” Read more

StephenW

肝癌风险，检测：近期有8例报道
2018年7月16日

患有肝病的患者如病毒性肝炎和患有肝硬化的非酒精性脂肪肝患者发展为肝细胞癌的风险增加，肝细胞癌也可导致肝外癌。研究人员最近发布了有关改善早期发现和诊断的因素的新数据，以及在HCC之前和治疗期间确定风险的因素。

Healio介绍了以下最近的报告，其中包括肝癌检测中的种族差异研究，两年一次的筛查改进诊断以及创新的非侵入性检测解决方案。


种族差异决定了肝癌的检测，结果

研究人员确定了与早期发现肝细胞癌和接受治愈性治疗相关的种族和种族差异，这些差异可用作改善患者预后的干预目标。

“与大多数恶性肿瘤一样，诊断时HCC肿瘤负荷会影响预后和治疗决策，”德克萨斯大学西南医学中心的医学博士Nicole E. Rich及其同事写道。 “理解和量化潜在的差异是确定干预目标和通知战略以减少现有差异的第一步。阅读更多

肝硬化双年度肝癌筛查可提高诊断，生存率

根据最近发表的一项研究，符合肝细胞癌监测与丙型肝炎或乙型肝炎相关代偿性肝硬化患者的早期诊断，更好的治疗方案分配和更长的总生存期相关。

法国HôpitalHenriMondor的医学博士Charlotte Costentin及其同事写道：“根据国际指南推荐，对肝硬化患者进行HCC监测是基于两年一次的超声检查。” “改善对监测指南的依从性应该可以显着改善这种致命癌症的预后。”阅读更多内容

小儿肝癌可能导致脑转移

根据已发表的研究结果，纤维板层肝细胞癌是一种罕见的儿童肝癌，转移至大脑，促使研究人员建议对晚期疾病患者进行监测神经影像学检查。

洛克菲勒大学细胞生物物理实验室教授Sanford M. Simon博士及其同事写道：“目前对纤维板层肝细胞癌的治疗主要集中在全切除术上，因为全身治疗仍未得到标准化。” “然而，纤维板层肝细胞癌经常被诊断为晚期，并且尽管切除，大多数在1年内复发。 ...有两例脑转移患者的报告存在于文献中，但都没有提供病变的神经影像学，病理学或分子学分析。“阅读更多

甲基化DNA标记物的血浆测定检测肝癌

在2018年消化疾病周的独家视频视角中，来自明尼苏达州罗切斯特市梅奥诊所的胃肠病学家John B. Kisiel博士分享了一项研究结果，其中甲基化DNA标记物的血浆检测检测到所有阶段的肝细胞癌。


“这些是我们在Mayo Clinic患者的冷冻组织标本中提取DNA的实验中发现的较大组的一部分，”Kisiel告诉Healio Gastroenterology and Liver Disease。 “本研究的目的是在更大的队列中验证这些标志物，其中包括一系列疾病阶段，包括可能治愈的早期患者。”在这里观察

Exact Sciences扩展了GI空间中的无创癌症检测

在2018年消化疾病周的独家行业视角中，精确科学公司首席执行官Kevin Conroy讨论了该公司的无创Cologuard结肠癌检测以及最近关于检测肝癌的非侵入性检测数据。

“精确科学的使命是帮助在根除结肠癌方面发挥作用，”康罗伊告诉Healio Gastroenterology and Liver Disease。 “我们开发了Cologuard，这是一种非侵入性粪便DNA测试，是FDA批准的第一个也是唯一一个粪便DNA测试。它被用来在美国筛选超过110万人，超过110,000名医生使用Cologuard。“在这里观看

Stivarga在多吉美治疗期间改善HCC预后

根据最近发表的一项研究，Stivarga疗法为肝细胞癌患者提供了临床益处，并且具有相似的不良事件发生率，无论最近的多吉美剂量或先前的多吉美疗法的进展时间如何。

来自加州大学洛杉矶分校David Geffen医学院的Richard S. Finn博士及其同事对RESOURCE试验进行了回顾性分析 - 结果显示Stivarga（regorafenib，Bayer）显着改善患者的总体生存率在多吉美（索拉非尼，拜耳）治疗期间，其HCC进展 - 以验证索拉非尼依次接受瑞格非尼治疗的顺序治疗结果。阅读更多

禁欲不会降低酒精相关性肝硬化患者的HCC风险

根据2018年国际肝病大会的一项报告，戒酒并未降低Child-Pugh A级或B级酒精相关性肝硬化患者的肝细胞癌风险。

西班牙阿斯图里亚斯中央医院的医学博士AndrésCastano-Garcia说：“我们的目标是调查禁欲是否会降低HCC监测计划中包括的一系列酒精性肝硬化患者的HCC风险。”在他的演讲中。 “禁欲被定义为没有任何饮酒消费，并根据患者的访谈确定。”阅读更多

新颖的分数可预测HBV抗病毒治疗期间的肝癌风险

根据最近公布的数据，研究人员在慢性乙型肝炎患者口服抗病毒治疗期间开发了肝细胞癌发展的预测风险评分。

“得分需要所有接受治疗的患者随时可获得的简单信息，”来自台湾辅仁天主教大学的医学博士Yao-Chun Hsu及其同事写道。 “通过对患有不同HCC风险的患者进行分层，易于应用的分数可以为[慢性HBV]抗病毒治疗时代的临床实践和医疗保健政策提供信息。”阅读更多