Review
Copyright ©2009 Baishideng. All rights reserved.
World J Hepatol. Oct 31, 2009; 1(1): 48-61
Published online Oct 31, 2009. doi: 10.4254/wjh.v1.i1.48
Surveillance and diagnosis of hepatocellular carcinoma in patients with cirrhosis
Lorenzo Andreana, Graziella Isgrò, Maria Pleguezuelo, Giacomo Germani, Andrew K Burroughs
Lorenzo Andreana, Graziella Isgrò, Maria Pleguezuelo, Giacomo Germani, Andrew K Burroughs, The Royal Free Sheila Sherlock Liver Center, Departement of Surgery, Royal Free Hospital, London, NW3 2QG, United Kingdom
Author contributions: Andreana L and Burroughs AK wrote the paper, Isgrò G conseived the figure, Pleguezuelo M and Germani G contributed equally on tables.
Correspondence to: Andrew K Burroughs, Professor, The Royal Free Sheila Sherlock Liver Center, Department of Surgery, Royal Free Hospital, Pond Street, London, NW3 2QG United Kingdom. andrew.burroughs@royalfree.nhs.uk
Telephone: +44-20-74726229 Fax: +44-20-74726226
Received: June 22, 2009
Revised: September 11, 2009
Accepted: September 18, 2009
Published online: October 31, 2009
Abstract

Early identification of hepatocellular carcinoma (HCC) is more frequent because of surveillance programs for HCC worldwide. The optimal strategy of surveillance in cirrhosis is a current topical issue. In terms of diagnosis, recent advances in non-invasive imaging technology, including various techniques of harmonic ultrasound, new ultrasound contrast agents, multi-slice helical computed tomography and rapid high quality magnetic resonance, have all improved the accuracy of diagnosis. Consequently the role of liver biopsy in diagnosis of HCC has declined. The imaging diagnosis relies on the hallmark of arterial hypervascularity with portal venous washout. However, with recent advances in genomics and proteomics a great number of potential serum and tissue markers have been identified and are being developed as new candidate markers for both diagnosis and prognosis of hepatocellular carcinoma, and may increase the need for liver biopsy.

Keywords: Hepatocellular carcinoma; Liver neoplasm; Screening; Diagnosis; Imaging; Liver biopsy; Molecular markers