肝细胞癌监测模式和肝硬化患者的结果
Darine Daher1, Karim Seif El Dahan1, Alva Cano1
1Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
概括
使用超声波加上α-fetoprotein (AFP) 或CT/MRI的肝细胞癌 (HCC) 监测有助于早期发现和治疗. 仅仅超声波对识别早期HCC的效果不那么好.
科学领域:
- 肝病学和瘤学 肝病学和瘤学
- 医疗成像医学成像
- 公共卫生 公共卫生
背景情况:
- 肝细胞癌 (HCC) 监测可以改善早期检测并降低死亡率,但实践模式和有效性各不相同.
- 了解当前的HCC监测策略对于优化患者治疗结果至关重要.
研究的目的:
- 在一个庞大的,多样化的美国患者队列中描述HCC监测模式.
- 为了比较不同监测策略对早期瘤检测,治愈治疗和生存的有效性.
主要方法:
- 在2008年至2022年期间诊断出2028名HCC患者的回顾性队列研究.
- 在HCC诊断前一年的肝脏成像 (超声波+AFP,仅超声波,CT/MRI) 分析.
- 多变量回归用于比较各监测组的结果.
主要成果:
- 超声波加AFP (34.7%) 和没有成像 (34.8%) 是最常见的监测方法.
- 在研究期间,CT/MRI使用量增加.
- 与没有成像或仅用超声波相比,CT/MRI和超声波加AFP与更早的HCC检测和更高的治愈治疗率有关.
结论:
- HCC监测实践不同,并影响临床结果.
- 超声波加AFP和CT/MRI在早期HCC检测方面比单独的超声波更有效.
- 在监视中,AFP对超声波起着补充作用,支持将其纳入指导方针.
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