Effi cacy of ultrasound as a screening test for early detection of hepatocellular carcinoma. A 6-year prospective study by ultrasound and alpha-fetoprotein

Simona Tripon, Mircea Grigorescu, Titus Şuteu, Horaţiu Branda, Adriana Cavaşi, Zeno Spârchez, Erica Chiorean, Radu Badea

Abstract


Background: Contrasting data have so far been reported on the utility and effi cacy in screening patients with cirrhosis for early detection of hepatocellular carcinoma. Aim: To determine the accuracy of ultrasound (US) examination and serum alphafetoprotein (AFP) in HCC diagnosis and the ultrasound’s effi cacy performed every 6 month in screening programs for early detection of HCC. Method: A 6-year prospective screening study was conducted by using both AFP and US every 6 months in order to detect HCC in 102 patients with cirrhosis. Results: Of 102 patients, 18 developed HCC. A value of 20 ng/ml AFP
(above which investigation for HCC is recommended) has a low sensitivity (39%) and specifi city (83%) in detecting HCC. The tumor was single and less than 3 cm in 66% of cases. Only one patient diagnosed with HCC was out of Milan criteria. Screening US detected the majority of the early stage HCC with a sensitivity of 94%. Conclusion: This study indicates that US examination was more accurate in detecting HCC compared with the AFP level. A regular US follow-up, timed at 6-month intervals according to the risk of HCC development in patients with cirrhosis, allowed the detection of liver carcinoma at an early stage in a high proportion of patients, possibly improving the prognosis of the disease.


Keywords


hepatocellular carcinoma; screening; ultrasound; alpha-fetoproteine

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