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1、Risk Factors2. Screening for HCC3. Diagnosis4. Evaluation5. Management,1. Risk Factors,Hepatitis B,C Alcohol Non-alcohol steatohepatitis(NASH) Primary biliary cirrhosis Environment exposure to aflatoxin Auto-immune hepatitis Inherited errors of metabolism Genetic hemochromatosisPorphyria cutanea tar
2、daAlpha1-antitrypsin deficiencyWilsons disease,2.Screening for HCC,Symptomsjaundice, anorexia, weight loss, malaise,upper abdominal pain Physical signshepatomegaly, ascites Paraneoplastic syndromeshypercholesterolemia, erythrocytosishypoglycemia,3.Diagnosis,Imaging,Biopsy,Serum biomarkers,Hepatitis
3、panel Assessment of the presence of comorbidity Imaging studies to detect the presence of metastatic disease Evaluation of hepatic function Portal hypertention,4.Evaluation,Staging (AJCC) TNM staging systemOkuda systemBCLCCLIPJIS,CLIP classification,Parameter Score ChildPugh A0 B1 C2 Tumour morpholo
4、gy Uninodular and extension 400 ng/ml 1 Macrovascular invasion No 0 Yes 1,Definition of the BCLC staging for HCC,Surgerypartial hepatectomyliver transplantation Local regional therapyablation: RFA PEIembolization: bland embolization(TAE) chemoembolization(TACE) radioembolization RT:conformal or stereotactic therapySystemic therapy Best supportive care,Management,Levels of bilirubin ,ALT, AST, ALP,LDH,albumin,protein Cr, BUN PT,INR,Child-pugh scoreMELD scoreserum bilirubin, creatinine, INR6(less ill)-40(gravely ill),
