早期肝细胞癌的检测:超声监测和监测依从性的回顾性评价。

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Translational gastroenterology and hepatology Pub Date : 2025-06-11 eCollection Date: 2025-01-01 DOI:10.21037/tgh-24-119
Adina Olaru, Anmol Gangi-Burton, Meetal Shah, Christopher Clarke, Suresh V Venkatachalapathy, James Franklin, Aloysious D Aravinthan
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引用次数: 0

摘要

背景:推荐每隔6个月进行一次肝细胞癌(HCC)超声检查。本研究探讨了早期HCC检测的相关因素。方法:纳入2019年至2022年期间所有首次新诊断为HCC的患者。根据肝脏影像学报告和数据系统(LI-RADS)标准独立审查所有治疗前影像学。早期HCC被定义为单一肿瘤结果:研究队列包括175例新发HCC患者。诊断时的中位年龄为71岁;78%为男性;中位体重指数(BMI)为29.3 kg/m2;94%是欧洲血统,最常见的病因是代谢功能障碍相关的脂肪变性肝病(MASLD)(58%)。三分之一(37%)通过初步监测(监测组)出现,其余在调查其他适应症时发现HCC(偶然组)。只有发病年龄[P=0.003;优势比(OR) 0.937, 95%可信区间(CI): 0.899-0.978)和接受HCC监测(pp结论:无论依从率如何,接受初级监测与早期HCC检测相关。即使没有严格遵守推荐的频率,也应尽可能多地将患者纳入初级监测规划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Detection of early-stage hepatocellular carcinoma: a retrospective evaluation of ultrasonography surveillance and surveillance adherence.

Background: Hepatocellular carcinoma (HCC) surveillance using 6-monthly ultrasonography (US) intervals is recommended. This study investigated the factors associated with early-stage HCC detection.

Methods: All patients with a new HCC diagnosis for the first time between 2019 and 2022 were included. All pre-treatment imaging was independently reviewed according to Liver Imaging Reporting and Data System (LI-RADS) criteria. Early-stage HCC was defined as a single tumour <50 mm or up to 3 tumours all <30 mm. Rate of adherence was expressed as the proportion of the number of 6-monthly surveillance US performed relative to the total number of surveillance US the patient should have undergone over the preceding 5 years or since the diagnosis of cirrhosis, if it was within the preceding 5 years.

Results: The study cohort included 175 patients with new HCC. The median age at diagnosis was 71 years; 78% were males; median body mass index (BMI) was 29.3 kg/m2; 94% were of European ancestry and the most common aetiology was metabolic dysfunction-associated steatotic liver disease (MASLD) (58%). One third (37%) presented through primary surveillance (surveillance group) and the remainder were found to have HCC when investigated for other indications (incidental group). Only the age at presentation [P=0.003; odds ratio (OR) 0.937, 95% confidence interval (CI): 0.899-0.978] and being on HCC surveillance (P<0.001; OR 5.867, 95% CI: 2.533-13.586), but not surveillance adherence were independently associated with early-stage HCC detection.

Conclusions: Being part of primary surveillance, irrespective of adherence rate, is associated with early stage HCC detection. As many patients as possible should be enrolled into primary surveillance programme, even if adherence to recommended frequency is not followed rigorously.

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