HCC的筛选(2005.2.19)

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Best Pract Res Clin Gastroenterol. 2005 Feb;19(1):101-18.

Screening for hepatocellular carcinoma.

Sherman M.

University of Toronto and Toronto General Hospital, 200 Elizabeth Street,
Toronto, Ont., Canada M5G 2C4.

There is currently no evidence that screening patients at risk for
hepatocellular carcinoma reduces mortality from the disease. Nonetheless,
screening is widely practiced. Screening is a process that includes
selecting patients, applying screening tests, deciding on recall policies,
and subsequently proving or disproving the presence of cancer. The
literature on screening for hepatocellular carcinoma is confusing at best,
and does not adequately consider the many biases that result from
uncontrolled and retrospective studies. Nonetheless, screening can be
justified because it is likely that mortality is decreased by adequate
treatment of small cancers, particularly in the era of liver
transplantation. False-positive screening test results are common. Once an
abnormal screening result is obtained there is little guidance from the
literature as to how patients should be investigated further, nor about how
to determine whether the screening test result was a false-positive. This
should at minimum include short interval follow-up with CT scans and MRI's.

PMID: 15757807 [PubMed - in process]