scholarly journals Assessment of Lens Culinaris Agglutinin-Reactive Fraction of Alpha Fetoprotein as an Early Diagnostic Marker for Hepatocellular Carcinoma among Sudanese Patients with Chronic Liver Disease

2014 ◽  
Vol 2 (1) ◽  
pp. 1-6
Author(s):  
Yousif M. Shata ◽  
Salma BM Mudawi ◽  
Suliman S. Fedail ◽  
Badr Aldeen Hassan Al Abd ◽  
Ammar Mohammed Ismaeil ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Lens Culinaris ◽  
Diagnostic Marker ◽  
Alpha Fetoprotein ◽  
Chronic Liver ◽  
Lens Culinaris Agglutinin ◽  
Early Diagnostic

scholarly journals The gut microbiome and hepatocellular carcinoma: Implications for early diagnostic biomarkers and novel therapies

Liver Cancer ◽  
2021 ◽  
Author(s):  
Yongbo Kang ◽  
Yue Cai ◽  
Ying Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Gut Microbiota ◽  
Chronic Liver Disease ◽  
Disease Progression ◽  
Chronic Liver ◽  
Therapeutic Modalities ◽  
Liver Disease Progression ◽  
Gut Microbe ◽  
Early Diagnostic

Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. HCC almost exclusively develops in patients with chronic liver disease, driven by a vicious cycle of liver injury, inflammation and regeneration that typically spans decades. Recently, increasing investigation of the microbiome–gut–liver axis enhances our understanding of the role of the gut microbiota in promoting the progression of liver disease and the development of HCC. In this review, we summarize mechanisms by which the gut microbiota promotes hepatocarcinogenesis, focusing on bacterial dysbiosis, the leaky gut, microbe-associated molecular patterns and bacterial metabolites as key pathways that drive cancer-promoting liver inflammation, fibrosis and genotoxicity. Furthermore, we discuss the important potential of gut microbiota as an early diagnostic biomarker of HCC. Gut microbiota may be as a promising target for the simultaneous prevention of chronic liver disease progression and HCC development in patients with advanced liver disease. We outlook in detail therapeutic modalities in which targeting the gut microbiota for the prevention of disease progression and HCC development seems promising.

scholarly journals Screening for hepatocellular carcinoma in chronic liver disease: A systematic review and meta-analysis of randomized controlled trials comparing screening methodologies

2021 ◽  
Author(s):  
James O'Connell
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Randomized Controlled Trials ◽  
Chronic Liver Disease ◽  
Alpha Fetoprotein ◽  
Chronic Liver ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
All Cause Mortality

Abstract BackgroundHepatocellular carcinoma (HCC) is the 5th most prevalent cancer and the second most common cause of cancer-related mortality worldwide. HCC is often asymptomatic until an advanced stage. Current guidelines recommend ultrasound surveillance with or without measurement of serum alpha-fetoprotein. Our objective was to determine if screening for HCC is beneficial or harmful in patients with chronic liver disease. Primary outcomes were all-cause mortality and quality of life. Secondary outcomes were mortality due to HCC, the number of cases of HCC detected and adverse events.MethodsThis is a systematic review and meta-analysis of data from randomized controlled trials. To be included trials had to randomize patients to either an HCC screening group or non-screening group, randomize patients to different screening frequencies or randomize patients to different screening methods. All published reports of randomized trials on screening for HCC were eligible for inclusion, irrespective of the language of publication. Studies had to include patients with chronic liver disease. Data extraction and analysis were performed independently by two reviewers.ResultsWhen screening with six-monthly alpha-fetoprotein and ultrasound abdomen was compared to no screening there was no evidence of difference in HCC related mortality when adjusted for clustering across a range of intracluster correlation coefficients (Intracluster coefficient (ICC) 0.02, odds ratio (OR) 0.60, 95% confidence interval (CI) 0.31-1.15). Screening with six-monthly alpha-fetoprotein when compared to a single alpha-fetoprotein check did not result in a statistically significant difference in all-cause mortality (OR 1.02, 95% confidence interval (CI) 0.65-1.60), mortality due to HCC (OR 1.01, 95% CI 0.57-1.78) or the number of HCC detected (OR 1.11 95% CI 0.64-1.92). There was no evidence of difference in all-cause mortality (OR 0.81, 95% CI 0.26-2.53), mortality due to hepatocellular carcinoma (OR 0.81, 95% CI 0.26-2.53) or the number of patients with HCC detected (OR 1.09 95% CI 0.40-2.99) when twice-a-year ultrasound was compared with annual CT. There was no statistically significant difference when screening more frequently was compared to less frequently in terms of all-cause mortality (OR 0.86, 95% CI 0.56-1.32), mortality due to hepatocellular carcinoma (OR 1.42, 95% CI 0.55-3.64) and the number of cases of hepatocellular carcinoma detected (OR 0.90 95% CI 0.47-1.71).ConclusionsThere is currently insufficient evidence from randomized controlled trials to support the routine screening for HCC in patients with chronic liver disease.

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