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Early Identification of Liver Cancer in Patients at Risk of Cirrhosis: The Role of Alpha-Fetoprotein and Liver Ultrasound in Detecting Focal Liver Lesions

A middle-aged Hispanic man in a medical office attentively observes a 3D model of a liver on a computer screen. The doctor, a Hispanic woman in her 40s, points to the model while explaining the importance of early detection of liver cancer, particularly in patients at risk of cirrhosis. The atmosphere is professional and warm, emphasizing patient education on focal liver lesions and the role of alpha-fetoprotein in diagnosis.

Liver cancer, specifically hepatocellular carcinoma (HCC), is one of the leading causes of cancer-related mortality worldwide. Cirrhosis is the primary risk factor for the development of this type of cancer, underscoring the importance of early identification in patients at risk of cirrhosis. Early detection allows for curative treatments to be applied in the initial stages, significantly improving patient prognosis.

Diving Deeper into Early Identification

Liver ultrasound every six months, with or without the measurement of alpha-fetoprotein (AFP), is the recommended screening strategy for the early detection of HCC in patients with cirrhosis. However, this strategy has deficiencies, such as suboptimal sensitivity in early stages and variability in the execution of the ultrasound. Recent studies suggest that adding AFP to the ultrasound improves sensitivity for the early detection of HCC [1].

Furthermore, the identification of focal liver lesions through advanced imaging techniques and the use of emerging blood biomarkers are being investigated as potential methods to enhance the early detection of HCC. The validation of these biomarkers could overcome the current limitations of ultrasound [2].

The implementation of surveillance programs for HCC has been shown to improve early-stage detection, access to curative treatments, and survival in patients with cirrhosis. However, the underutilization of these programs remains a significant challenge [3].

Conclusions

Early detection of liver cancer in patients at risk of cirrhosis is crucial for improving clinical outcomes. The combination of liver ultrasound and alpha-fetoprotein remains the standard strategy, although new tools are being developed and validated to enhance screening accuracy and effectiveness. Continuous education and the implementation of effective surveillance programs are essential to maximize the value of HCC screening in clinical practice.

References


Created 13/1/2025