What tumor markers should be used to detect hepatocellular carcinoma?

Serum alpha fetoprotein (AFP) is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis.

What is the modality of choice for imaging hepatocellular carcinoma?

The accepted modality for hepatocellular carcinoma screening is ultrasound. Once HCC is suspected then CT or MRI may be used to confirm the diagnosis and establish the tumor burden for staging purposes. The BCLC classification system is the most frequently used for treatment planning.

What is the key laboratory finding in hepatocellular carcinoma?

The focus of much research revolves around diagnostic strategies to identify early HCC, defined by size of tumor and number of lesions. Diagnostic tools commonly used include the serum tumor marker alfa-fetoprotein (AFP), radiographic imaging, and liver biopsy.

How is sarcomatoid carcinoma diagnosed?

It is considered to be a biphasic tumor made up of epithelial as well as spindle cell component, but of epithelial origin. The diagnosis often represents a clinicopathologic challenge, and immunohistochemistry plays a key role in the histopathological diagnosis.

How quickly does HCC progress?

The estimated time needed for a HCC to grow from 1 cm to 2 cm was 212 days in patients with HBV infection and 328 days in those with HCV infection.

What do tumor markers tell you?

A tumor marker is anything present in or produced by cancer cells or other cells of the body in response to cancer or certain benign (noncancerous) conditions that provides information about a cancer, such as how aggressive it is, what kind of treatment it may respond to, or whether it is responding to treatment.

What is elevated in hepatocellular carcinoma?

The levels of AFP, AFP-L3, and DCP usually increase as HCC progresses, i.e., with increases in the size and number of HCC lesions and progression to portal vein invasion [18,19,20,21,22].

How do you screen for hepatocellular carcinoma?

Ultrasound. U/S is currently the only screening test recommended by regional liver societies as part of surveillance for HCC. This involves firstly identifying a pre-specified patient population at relatively high risk of developing cancer and inviting them for regular screening with U/S for early detection of cancer.

What does HCC look like on CT scan?

On unenhanced images, the appearance of HCC is variable and depends on the surrounding liver parenchyma and etiology of chronic liver disease. Most often, HCCs appear hypodense or isodense (Fig. 1) to the liver on unenhanced images but may appear hyperdense when they develop in a background of fatty liver.

What is a CT triple phase?

The triple-phase liver CT protocol is a useful examination in the assessment of focal liver lesions, hypervascular liver metastases and endocrine tumors. It involves a dedicated late arterial phase, portal venous phase and delayed phase acquisition.