Dépistage, diagnostic et suivi biologique du carcinome hépatocellulaire

Hepatocellular carcinoma (HCC) is the fifth 0689 1474V 2 most commom cancer worldwide. Cirrhosis caused by HBV, HCV or chronic alcohol intake are associated with the major risk. Systematic screening for HCC of asymptomatic patients with cirrhosis are needed to detect earlier small tumors requiring treatments (liver transplantation, surgical resection, percutaneous techniques). Screening strategy among cirrhotic patients based on regular liver ultrasonography associated or not with serum alpha-fetoprotein (AFP) assay, is actually recommended. As the performance of AFP is not satisfaying, additional tumoral markers are proposed (des-gamma -carboxyprothrombin, glycosylated AFP-L3 fraction). Currently, diagnosis of HCC in cirrhotic patients includes noninvasive tests (imaging after contrast administration, AFP assay); diagnostic biopsy is performed when imaging is limited. After treatment, tumor recurrence is assessed by a regular follow-up (AFP assay and imaging). Currently, despite the lack of accurate markers, recent developments in global genomic and proteomic approaches will allow discovery of new biomarkers of the primary tumor as well as recurrence.