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

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
- [1] Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis
- [2] Blood-based biomarkers for hepatocellular carcinoma screening: Approaching the end of the ultrasound era?
- [3] Hepatocellular carcinoma surveillance - utilization, barriers and the impact of changing aetiology
Created 13/1/2025