Hepatocellular Carcinoma: The Search for an Optimal Screening Test

Area of Science:

• Hepatology and Oncology
• Cancer Biomarkers
• Diagnostic Imaging

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally, often arising from chronic liver disease (CLD).
• Current screening methods like ultrasound and alpha-fetoprotein (AFP) have limitations in sensitivity and specificity.
• Early detection of HCC is crucial for improving patient survival rates through timely curative treatment.

Purpose of the Study:

• To review recent advancements in screening tests for early hepatocellular carcinoma (HCC) detection.
• To highlight promising novel biomarkers and combined algorithms for HCC surveillance.
• To provide an overview of screening strategies evaluated over the past decade.

Main Methods:

• Review of scientific literature focusing on HCC screening tests and biomarkers.
• Analysis of studies published within the last decade concerning early HCC detection.
• Evaluation of diagnostic performance of various biomarkers and scoring systems.

Main Results:

• Alpha-fetoprotein (AFP) has limited accuracy for HCC detection, necessitating improved methods.
• Emerging biomarkers such as lens culinaris agglutinin-reactive AFP, des-gamma-carboxy prothrombin, and circulating tumor markers show promise.
• Combination biomarker approaches, including the GALAD score and Doylestown algorithm, may enhance early HCC detection.

Conclusions:

• There is a critical need for more sensitive and specific biomarkers for early HCC detection.
• Novel biomarkers and integrated algorithms represent a significant advancement in HCC surveillance strategies.
• Continued research into innovative screening tools is essential for improving outcomes in patients at risk for HCC.