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To standardize the effective prevention, surveillance, and diagnosis of primary liver cancer, the Chinese Society of Hepatology, Chinese Medical Association, invited clinical experts and methodologists to develop the Consensus on the Secondary Prevention of Primary Liver Cancer, which was based on the clinical and scientific advances on hepatocellu...
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... factors; secondary prevention is to control the relevant causes and risk factors, and carry out risk-stratified surveillance in the population with chronic liver disease, thereby reducing or delaying the occurrence of HCC; tertiary prevention is to further reduce HCC recurrence and mortality, and improve overall survival after radical treatment ( Fig. 1). With recent progress in basic and clinical research and the development of diagnostic techniques, the formulation of a consensus on secondary prevention of primary liver cancer will provide an important basis for prevention and control of liver ...
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Citations
... Here, we have presented a systematic review of several dimensions of the impact of gender differences on HCC, including the genetic background of the disease, pathogenesis, treatment response, and prognosis. The aim is to promote a more precise medical approach, leading to better outcomes for all patients with liver cancer (Nan et al., 2021). ...
... Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, with low rates of early diagnosis and surgical resection. In China, HCC ranks third Diagnostics 2023, 13 in cancer-related mortality [1], and approximately 86% of hepatocellular carcinoma are associated with chronic Hepatitis B virus infection [2]. Currently, the early detection of HCC mainly relies on imaging examinations, serum alpha-fetoprotein (AFP), and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) levels [3]. ...
Background:
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, with low rates of early diagnosis and surgical resection. In recent years, with the rapid development of liquid biopsy technology, circulating tumor DNA (ctDNA) has emerged as a research hotspot in the field of precision medicine for liver cancer. Existing studies have demonstrated the suitability of ctDNA for combined detection with other liver cancer diagnostic markers, enabling a multi-index analysis. In recent years, a novel prediction model has been developed for early liver cancer screening based on ctDNA liquid biopsy, M2P-HCC (methylation, mutation, and protein-HCC), mainly incorporating methylation changes, gene mutations, and protein markers associated with liver cancer. Preliminary validation in the HCCscreenTM Investigational (HIT, ChiCTR1800020233) study, which focused on screening early liver cancer in communities with Hepatitis B surface antigen (HBsAg) positivity, yielded promising results with 100% sensitivity and 94% specificity. However, it remains uncertain whether M2P-HCC can be effectively applied in high-risk populations for Hepatitis B-associated liver cancer, warranting further research.
Methods:
Patients who were under long-term follow-up at the outpatient clinic of the Infectious Diseases Center of West China Hospital of Sichuan University from December 2020 to January 2023 were recruited in this prospective observational study and underwent the M2P-HCC test. The study population consisted of high-risk patients with Hepatitis B-related liver cancer who met the inclusion criteria. Patients with a history of previous malignancy, recent blood transfusion, autoimmune diseases, and human immunodeficiency virus (HIV) infection were excluded. Clinical data were collected at a baseline, and all patients underwent the M2P-HCC blood test. Based on the test results, they were categorized into positive, early-warning, and negative groups. Prospective cohort observation and regular follow-ups were performed for 6-8 months.
Results:
313 patients met the inclusion criteria and were included in the study. After 6-8 months of follow-up, HCC occurred in 41(13.1%) participants. The M2P-HCC test demonstrated good predictive performance with an area under the curve (AUC) of 0.88 (95% CI: 0.81-0.95, p < 0.001) and a cutoff value of 83 points (sensitivity 82.9% and specificity 85.7%). In contrast, the combination of alpha-fetoprotein (AFP) and ultrasound (US) yielded an inferior predictive performance (AUC 0.76 (95% CI: 0.69-0.84, p < 0.001), sensitivity 58.5%, and specificity 94.1%). Multivariate analyses revealed that M2P-HCC was an independent predictor of increased risk of HCC (OR = 1.16 [1.09-1.22], p < 0.001).
Conclusions:
M2P-HCC liquid biopsy demonstrated good performance for early liver cancer screening in high-risk populations of Hepatitis B-related liver cancer, exhibiting better sensitivity than the combination of AFP and US.
... Studies have shown that the overall sensitivity of ultrasound, CT, and MRI for Liver cancer is about 32-63%, 66-79%, and 84-90%, respectively [23]. For small liver cancers with a diameter of 2 cm, the sensitivity of Gd-EOB-DTPAenhanced MRI can reach 90%-96% [24]. The advantages such as high soft tissue resolution, the capacity of multiplane imaging and lack of ionizing radiation make MRI very suitable for guiding ablation therapy. ...
Objective
To investigate the feasibility and efficacy of real-time 3.0 T magnetic resonance imaging (MRI) guided percutaneous microwave ablation (MWA) in the treatment of multifocal liver cancer.
Methods
A total of 76 lesions in 26 patients with multifocal liver cancer who underwent 3.0 T MRI-guided microwave ablation in our hospital from April 2020 to April 2022 were retrospectively analyzed. The technical success rate, average operation time, average ablation time, and complications were evaluated. The upper abdomen was reviewed by pre- and post-contrast enhanced MRI scan every 1 months after the operation. The short-term curative effect was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria (2020 version), and the local control rate was calculated.
Results
All 76 lesions were successfully operated. The technical success rate was 100%, the average operation time was 103.58 ± 18.57 min, the average ablation time of a single lesion was 11.00 ± 4.05 min, and the average ablation power was 43.03 ± 4.45 W. There were no serious complications such as massive bleeding, liver failure, and infection after the operation, except in one case with a small amount of pleural effusion and one case with right upper abdominal pain. The average follow-up time was 13.88 ± 6.62 months. One patient died due to liver failure, and one lesion developed a local recurrence. The local control rate was 98.7%.
Conclusions
MWA of multifocal liver cancer guided by real-time 3.0 T MRI is a safe and feasible technique and has excellent short-term efficacy.
... In November 2021, the Chinese Society of Hepatology, Chinese Medical Association issued Consensus on the Secondary Prevention of Primary Liver Cancer [3]. A panel of experts consisting clinical epidemiologists, hepatologists, hepatobiliary surgeons,interventional radiologists, and oncologists, were organized to formulate the Consensus on Tertiary Prevention of Primary Liver Cancer based on the current scientific evidence and practicing norms in the risk factors, pathological mechanisms, preventive measures, surveillance and diagnostic techniques, and related treatment of HCC recurrence in the clinical practice in the Asia-Pacific region and worldwide. ...
... Methods for surveillance and diagnosis of HCC intrahepatic recurrence can refer to Consensus on Secondary Prevention of Primary Liver Cancer [3]. HCC serum marker levels, imaging changes in the liver and extrahepatically involved organs can be used to assess HCC intrahepatic recurrence and extrahepatic metastasis, combined with histopathological examination of tumors when necessary. ...
To effectively prevent recurrence, improve the prognosis and increase the survival rate of primary liver cancer (PLC) patients with radical cure, the Chinese Society of Hepatology, Chinese Medical Association, invited clinical experts and methodologists to develop the Consensus on the Tertiary Prevention of Primary Liver Cancer , which was based on the clinical and scientific advances on the risk factors, histopathology, imaging finding, clinical manifestation, and prevention of recurrence of PLC. The purpose is to provide a current basis for the prevention, surveillance, early detection and diagnosis, and the effective measures of PLC recurrence.
... To meet the aforementioned challenges, consensus on the primary, secondary, and tertiary prevention of primary liver cancer has been published in China in 2018, 2021and 2022, respectively [18][19][20] . Universal infant HBV vaccination combined with a triple elimination program to prevent mother-to-child transmission of human immunodeficiency virus, syphilis, and HBV 21 , together with large-scale diagnosis and treatment of CHB will eventually reduce the incidence of HCC. ...
... Periodic alpha-fetoprotein (AFP) testing is recommended for specific risk groups in the United States, according to guidelines for HCC screening, testing, diagnosis, and treatment issued by the American Association for the Study of Liver Diseases (AASLD). 55 AFP is the most widely used serum marker for auxiliary diagnosis of liver cancer. AASLD suggested risk groups include cirrhotic patients and some noncirrhotic hepatitis B carriers. ...
... AASLD suggested risk groups include cirrhotic patients and some noncirrhotic hepatitis B carriers. 55 Meanwhile, the National Comprehensive Cancer Network (NCCN) recommends ultrasonography (US) every six months for patients with specific causes of cirrhosis, including HBV/HCV, alcohol, hereditary hemochromatosis, and nonalcoholic fatty liver disease. 55 A trial of AFP screening for HCC has also been conducted in China, with risk groups defined as those with hepatitis, hepatitis B virus carriers, history of blood transfusion, or family history of HCC. 4 The screening program, which has been in place in select cities for 20 years, has been shown to diagnose HCC early and treat it symptomatically to improve patient survival. ...
... 55 Meanwhile, the National Comprehensive Cancer Network (NCCN) recommends ultrasonography (US) every six months for patients with specific causes of cirrhosis, including HBV/HCV, alcohol, hereditary hemochromatosis, and nonalcoholic fatty liver disease. 55 A trial of AFP screening for HCC has also been conducted in China, with risk groups defined as those with hepatitis, hepatitis B virus carriers, history of blood transfusion, or family history of HCC. 4 The screening program, which has been in place in select cities for 20 years, has been shown to diagnose HCC early and treat it symptomatically to improve patient survival. 53 Chemoprophylaxis is also a secondary preventive measure in the experimental phase. ...
According to the WHO, liver cancer is the third leading cause of cancer death globally and primarily affects developing countries. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and can be caused by aflatoxins. More than 53 percent of HCC patients worldwide come from China, while in the United States, hepatocellular carcinoma is a relatively rare cancer. This essay focuses on aflatoxin-induced HCC, analyzing the extent of aflatoxin contamination, the incidence of HCC, the leading causes, and the relevant laws and regulations of the two countries. China is one of the world's largest importers of food and animal feed, and the United States is the world's top food exporter. Therefore, the public health and food safety issues caused by aflatoxins have received significant attention in both countries. In addition, there are differences between the two countries regarding food production and handling environments, legislative aspects, and responses to public health issues. Comparing the leading causes of HCC in the two countries, it was found that the incidence of HCC the HBV-infected population were higher in Asia due to ethnic differences and different types of hepatitis viruses prevalent in the two countries. Nevertheless, comparing the incidence and significant causes of HCC among Japanese, Asians living in the U.S., and identical twins, environmental factors were more influential than genes. Therefore, aflatoxins are the main HCC risk factor of concern herein. Both countries have room for improvement in food quality regulation, work exposure regulation, popular science and publicity, and HCC prevention. In the discussion section, recommendations are made to the relevant governing departments of the two countries.
... ere are about 650,000 new hepatocellular carcinoma (HCC) cases every year, and over half of the new cases are in China. HCC becomes one of the most hazardous malignant tumors [2]. At early phase of HCC, patients' clinical symptoms are not obvious and more recessive and undetectable compared with other cancers [3]. ...
... In equation (2), ∅(x r ) referred to the features of samples after x r being mapped. 2 Computational Intelligence and Neuroscience ...
To investigate the evaluation of therapeutic effects of computerized tomography (CT) imaging machine learning classification algorithm-based transcatheter arterial chemoembolization (TACE) on primary hepatocellular carcinoma (PHC), machine learning algorithm was optimized to propose the feature extraction of soft margin, analyze CT images, and acquire relevant texture features to assess if it can predict the multistage features of PHC for the application of the therapeutic effects of TACE on PHC. Besides, PHC patients receiving surgical excision were retrospectively collected, and then 483 patients with hepatocellular carcinoma (HCC) were determined from cases. After that, a total of 162 cases meeting the standards were selected. Besides, the features of images were classified and analyzed by machine learning algorithm, and volume of interest (VOI) images of patients in each group were acquired by image segmentation layer by layer. In addition, the texture features of images were extracted. The results showed that 5 CT image-based texture features, including 2 histogram features and 3 matrix-based features, all described the specificity and heterogeneity of tumors. The analysis of the diagnostic effectiveness of the evaluation of response group by each texture parameter demonstrated that its sensitivity, specificity, and area under curve (AUC) were 83.63%, 90.91%, and 0.08%, respectively. Based on CT prediction, machine learning algorithm was fused to realize excellent classification effects on multistage and multiphase features and offer imaging support to the clinical selection of reasonable therapeutic plans. In addition, multiphase and multifeature-based medical tumor classification method was put forward.
Background and Aims: Hepatocellular carcinoma (HCC), a prevalent solid organ malignancy, is intricately linked to the glycolytic enzyme Alpha-enolase (ENO1). ENO1's overexpression is associated with malignant tumor progression and poor clinical outcomes, yet its role in HCC cell proliferation and differentiation warrants further investigation. This study focuses on identifying ENO1-interacting proteins in HCC, exploring their involvement in cell proliferation and the cell cycle.
Materials and Methods: We employed RNA interference to downregulate ENO1 in HepG2 cells, evaluating effects on cell proliferation, cycle progression, and key signaling pathways using MTT assays, flow cytometry, and Western blotting. Identifying ENO1-interacting proteins involved combining RNAi and co-immunoprecipitation with isobaric tags (iTRAQ). We confirmed five proteins central to proliferation and cell cycle regulation through immunofluorescence microscopy and additional co-immunoprecipitation. Pathway analysis and follow-up experiments were conducted for further elucidation.
Results: ENO1 silencing significantly inhibited HepG2 cell proliferation and extended G2/M and S phases. We identified 40 ENO1-interacting proteins with notable expression changes, including PCNA, HSP90, PCBP1, PSME1, and PEBP1. Significant downregulation was observed in PCNA, various cyclins, and phosphorylated ERK1/2, MAPK, and AKT, alongside an upregulation of P21. However, levels of CDK1, CDK2, ERK1/2, MAPK, and AKT remained unchanged.
Conclusions: This study highlights the glycolytic pathway's crucial role in HCC development. The identified ENO1-interacting proteins like PCNA, HSP90, PCBP1, PSME1, and PEBP1 are key in tumor development, differentiation, invasion, and metastasis. The interaction between ENO1 and PCNA, influencing cell cycle regulators and phosphorylation processes, offers new insights into HCC molecular dynamics and potential therapeutic avenues.
