Cirrhose et carcinome hépatocellulaire : diagnostic et suivi biologique

Liver cirrhosis is a common and growing public health problem with high morbidity and mortality that can be controlled by adequate surveillance programs performed by experienced personnel. Early diagnosis is crucial for curative treatments. Cirrhotic patients are recommended to undergo HCC surveillance by abdominal ultrasounds every 6 months. Serum biomarkers such as alpha-fetoprotein can help diagnosis and surveillance of cirrhosis evolution, HCC development and treatments efficacy. However, the use of α-fetoprotein as an independent tool for HCC surveillance is not recommended by current guidelines due to its low sensitivity and specificity. Molecular classification of HCC based on gene signature or gene sequence abnormalities are not ready for clinical application. Clinical practice is based on staging algorithms for treatment decisions that includes the evaluation of tumor stage, cirrhosis stage, functional performance status according to recommendations from guidelines.