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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
오류제보하기
Hepatocellular carcinoma (HCC) is one of the major cancers with a high incidence and mortality in Korea. A Korean multidisciplinary collaborative committee consisting of hepatologists, radiologists, epidemiologists and family medicine doctors systematically reviewed clinical practice guidelines in the world and literatures. The level of evidence for each recommendation was assessed and discussed to reach a consensus. Meta-analysis was also conducted to evaluate the grade of recommendation for the five key questions. Several randomized controlled studies and cohort studies showed a survival gain associated with surveillance for those at risk of developing HCC. The target populations for HCC surveillance were identified as hepatitis B virus or hepatitis C virus carriers and cirrhotic patients, since numerous studies revealed that these patients have significantly higher risk of HCC compared with non-infected or non-cirrhotic controls.
Individual surveillance strategy according to treatment history or degree of fibrosis in patients with viral hepatitis remains to be settled. Based on several cohort and randomized studies, a surveillance interval of six months was recommend.
The starting age of surveillance was determined as 40 years from the epidemiologic data. Although ultrasonography (US) is the mainstay for detection of HCC, its sensitivity is not fully accepted. Measurement of serum alpha-fetoprotein can complement US examination, increasing the sensitivity of HCC detection. The recommendation for HCC surveillance is that those with hepatitis B virus (or hepatitis C virus) infection or cirrhosis should have liver US and serum alphafetoprotein measurement every six months from 40 years of age or at the time of diagnosis of cirrhosis.
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등록된 정보가 없습니다.
참고문헌 (43)
참고문헌 신청
Omata M / 2010 / Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma / Hepatol Int 4:439~474
Singapore Ministry of Health / 2010 / Cancer screening : clinical prac-tice guidelines / Ministry of Health
New Zealand Ministry of Health / 2009 / New Zealand Guidelines Group. Suspected cancer in primary care : guidelines for investi-gation, referral and reducing ethnic disparities / New Zealand Guidelines Group
National Institute for Health and Care Excellence / Hepatitis B (chronic) : diagnosis and management of chronic hepatitis B in children, young people and adults
Kokudo N / 2009 / Evidence-based clinical practice guidelines for hepatocellular carcinoma in Japan : the J-HCC guidelines / J Gastroenterol 44(19):119~121
Singapore Ministry of Health / 2010 / Cancer screening : clinical prac-tice guidelines / Ministry of Health
New Zealand Ministry of Health / 2009 / New Zealand Guidelines Group. Suspected cancer in primary care : guidelines for investi-gation, referral and reducing ethnic disparities / New Zealand Guidelines Group
National Institute for Health and Care Excellence / Hepatitis B (chronic) : diagnosis and management of chronic hepatitis B in children, young people and adults
Kokudo N / 2009 / Evidence-based clinical practice guidelines for hepatocellular carcinoma in Japan : the J-HCC guidelines / J Gastroenterol 44(19):119~121
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