Hepatocellular carcinoma (HCC), the main primitive liver cancer, occurs almost exclusively in patients with cirrhosis. Only small tumors are accessible to curative treatments. Such tumors being ...asymptomatic, their detection needs to perform regular surveillance, using ultrasonography every 6 months, in patients with compensated cirrhosis. Several cues suggest that more than 75% of patients with HCC have not been included in such a surveillance program or that screening has been performed using inadequate modalities. The main paths to improve this status include: a) to increase the detection of patients with cirrhosis in the general population by sensitizing healthcare professionals to the diagnosis of cirrhosis and by developing the use of non invasive diagnostic methods; b) to extend HCC screening to all patients with compensated cirrhosis and to educate healthcare professionals about precise modalities; c) to develop a multidisciplinary approach to ensure the appropriate management of patients.
Chronic liver diseases complications generally occur when fibrosis progresses to cirrhosis. It is recognised that some patients do not progress while others develop significant fibrosis. Factors ...influencing the fibrosis progression rate are especially studied in chronic hepatitis C. Among many identified factors, the most important are those warranted a medical action such as alcohol consumption, obesity, other metabolic disorders and immunosuppression in case of HIV-HCV coinfection. Especially, in case of chronic liver disease, regular alcohol consumption should be avoided; overweight and metabolic disorders should be controlled. The control of liver damage aetiologies could decrease or even stop fibrosis progression.
This radioimmunoassay for type I collagen mainly detects degradation products of the molecule in human serum samples. Type I collagen antigenicity in serum can be separated into two peaks by ...gel-filtration chromatography. The larger form represents collagen molecules (as shown by immunoblotting experiments), and (or) type I collagen with aminoterminal propeptide or intact procollagen molecules. The smaller form, the exact nature of which is not known, is quantitatively the principal antigenic form and is derived from degradation of type I collagen. The concentration of type I collagen in serum is increased mainly in cirrhotic patients, with or without active liver disease, but also somewhat in alcoholic patients without cirrhosis.
