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HCC‐Früherkennung bei Patienten mit chronischen Lebererkrankungen

HCC screening in patients with chronic liver diseases

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Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist eine häufige Komplikation bei Patienten mit chronischen Lebererkrankungen. Insbesondere Patienten mit fortgeschrittener Leberfibrose oder bestehender Leberzirrhose sowie Patienten, die an einer chronischen Hepatitis-B-Virus-Infektion leiden, haben ein hohes Risiko für die Entstehung eines HCC.

Da die Prognose von Patienten mit fortgeschrittenem HCC extrem schlecht ist und nur in Frühstadien kurative Therapieoptionen bestehen, kommt einer frühzeitigen Diagnose des HCC eine entscheidende Bedeutung zu. Patienten mit einem erhöhten HCC-Risiko sollte in halbjährlichen Abständen eine Abdomensonographie zur Früherkennung von Lebertumoren angeboten werden.

Ein bis jetzt ungelöstes Problem stellt die massive Zunahme von Fettleberkrankungen als Folge von Diabetes, Übergewicht und körperlicher Inaktivität dar, an denen bis zu 30 % der Bevölkerung leiden. Die Identifikation der Patienten mit Fettlebererkrankungen, die ein hohes Risiko besitzen, an einem HCC zu erkranken und damit in Früherkennungsprogramme eingeschlossen werden sollten, wird eine der großen Herausforderungen der nächsten Jahre sein.

Abstract

Hepatocellular carcinoma (HCC) is a frequent complication in patients with chronic liver diseases. Particular patients with advanced fibrosis or liver cirrhosis and patients with chronic hepatitis B virus infection are at high risk for HCC. As patients with advanced HCC have a poor prognosis and curative therapeutic options are only available in early stages, an early detection of HCC is of high importance. Patients with an increased risk for HCC development should undergo abdominal ultrasound for early detection of HCC every 6 months. A still unsolved problem is the massive increase in non-alcoholic fatty liver disease (NAFLD) resulting from diabetes, overweight and physical inactivity, affecting approximately 30% of the population. The identification of patients with non-alcoholic steatohepatitis (NASH) who have an increased risk of HCC and who should be included in an early screening program, will be one of the biggest challenges in the coming years.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. O. Waidmann, T.M. Welzel und J. Trojan geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    O. Waidmann, T.M. Welzel & J. Trojan

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  1. O. Waidmann
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  2. T.M. Welzel
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  3. J. Trojan
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Correspondence to O. Waidmann.

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Waidmann, O., Welzel, T. & Trojan, J. HCC‐Früherkennung bei Patienten mit chronischen Lebererkrankungen. Gastroenterologe 10, 21–25 (2015). https://doi.org/10.1007/s11377-014-0940-1

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