肝细胞癌患者肝细胞癌监测计划异常成像的频率和结果。

StephenW

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Frequency and Outcomes of Abnormal Imaging in Patients with Cirrhosis Enrolled in a Hepatocellular Carcinoma Surveillance Program.
Konerman MA, et al. Liver Transpl. 2018.
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Abstract

BACKGROUND: There are limited data on downstream effects of hepatocellular carcinoma (HCC) surveillance, including frequency of false positive results. We aimed to quantify the incidence of indeterminate nodules and follow-up testing needed to resolve these findings among patients enrolled in a structured HCC surveillance program.

METHODS: We retrospectively analyzed adult cirrhosis patients enrolled in a structured HCC surveillance program in a large tertiary care center. Outcomes included surveillance benefits, defined as early HCC detection, and harms, defined as indeterminate nodules prompting additional diagnostic evaluation.

RESULTS: Among 999 patients followed for a median of 2.2 years, HCC surveillance imaging was consistently completed every 6, 9, and 12 months in 46%, 51% and 68% of patients, respectively. Of 256 (25.6%) patients with abnormal imaging 69 (26.9%) were diagnosed with HCC and 187 (73.1%) with indeterminate nodules. Most HCC (n=54, 78.3%) were found within Milan Criteria. Among those with an indeterminate nodule, 78.1% returned to ultrasound surveillance after a median of 2 (IQR 1-3) negative CT/MRI and 21.8% continued CT/MRI imaging (median 2; IQR 1-2). Eleven patients underwent diagnostic liver biopsy. Hypoalbuminemia, thrombocytopenia and larger nodule size were independently associated with HCC diagnosis.

CONCLUSION: One in four patients enrolled in an HCC surveillance program had abnormal surveillance imaging, but three-fourths of the lesions were indeterminate nodules, resulting in downstream harms. Improved risk-stratification tools are needed to identify nodules that are benign to reduce follow-up diagnostic evaluation. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
PMID 30582779 [ - as supplied by publisher]

StephenW

肝细胞癌患者肝细胞癌监测计划异常成像的频率和结果。
Konerman MA，et al。肝脏透明。 2018。
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背景：关于肝细胞癌（HCC）监测的下游效应的数据有限，包括假阳性结果的频率。我们的目的是量化不确定结节的发生率，以及在参加结构化HCC监测计划的患者中解决这些发现所需的后续检测。

方法：我们回顾性分析了在大型三级医疗中心参加结构化HCC监测计划的成人肝硬化患者。结果包括监测效益，定义为早期HCC检测和危害，定义为不确定的结节，促使进行额外的诊断评估。

结果：在随访中位数为2。2年的999例患者中，HCC监测成像分别在46％，51％和68％的患者中每6,9和12个月持续完成。 256例（25.6％）异常成像患者中69例（26.9％）被诊断为HCC，187例（73.1％）有不确定结节。大多数HCC（n = 54,78.3％）在米兰标准中被发现。在具有不确定结节的患者中，78.1％在中位数2（IQR 1-3）阴性CT / MRI后恢复超声监测，21.8％继续CT / MRI成像（中位数2; IQR 1-2）。 11名患者接受了肝脏活检诊断。低蛋白血症，血小板减少症和较大的结节大小与HCC诊断独立相关。

结论：参加HCC监测计划的患者中有四分之一具有异常监测成像，但四分之三的病灶是不确定的结节，导致下游危害。需要改进风险分层工具，以确定有利于减少后续诊断评估的结节。本文受版权保护。版权所有。
本文受版权保护。版权所有。
PMID 30582779 [ - 由出版商提供]