Efficacy of a surveillance program for early detection of hepatocellular carcinoma.

Istituto di Clinica Medica Generale e Terapia Medica, University of Bologna, Italy.
Cancer (Impact Factor: 4.9). 09/1996; 78(5):977-85. DOI: 10.1002/(SICI)1097-0142(19960901)78:5<977::AID-CNCR6>3.0.CO;2-9
Source: PubMed

ABSTRACT Contrasting data have so far been reported on the utility and efficacy of screening patients with cirrhosis for early detection of hepatocellular carcinoma (HCC). The goal of this study was to evaluate the efficacy of a regular ultrasonographic and laboratory follow-up for the early detection of small HCC, and to identify parameters correlated with a higher risk of developing HCC.
One hundred and sixty-four consecutive patients with liver cirrhosis living in Emilia Romagna, Italy, were enrolled in the period 1989-1991. All patients underwent clinical, biochemical, and ultrasonographic evaluations at entry and at 3- and 6-month intervals during follow-up.
By April 1995, 34 patients had developed HCC. In 76% of the patients, ultrasonography identified HCC when it was still single and small (< 4 cm). At discriminant, logistic regression and univariate analyses, sex and the entry concentration of alkaline phosphatase, alpha-fetoprotein, gamma-glutamyl transpeptidase, and albumin were associated with a higher risk of developing HCC, whereas at multivariate analysis (Cox's model), only sex and the entry concentration of alkaline phosphatase, albumin, and alpha-fetoprotein were independently and significantly related to the appearance of HCC.
A regular ultrasonographic follow-up, timed at 3- to 6-month intervals according to the risk of HCC development in patients with cirrhosis, allows the detection of liver carcinoma at an early stage in a high proportion of patients, possibly improving the prognosis of the disease.

Download full-text


Available from: Giampaolo Bianchi, Oct 09, 2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cadmium sulfide (CdS) quantum dots (QDs) were coupled to an Au nanoimmunosensor on a quartz crystal microbalance (QCM) to form the basis of an ultrasensitive and label-free sensor of annexin A3 (ANXA3), a lung and prostate cancer biomarker protein. Polyclonal anti-ANXA3 antibody was covalently immobilized on the CdS QDs, which had previously been functionalized with carboxyl groups and bound to a cystamine self-assembled monolayer on the Au/QCM. Frequency changes induced by the binding of ANXA3 to the anti-ANXA3 on the probe's surface allowed the very sensitive detection of GST-ANXA3 with a detection limit of 0.075 ± 0.01 ng/mL. The sensor could detect ANXA3 at 0.1 ng/mL in spiked human blood and urine samples in less than 15 min without any interference from other proteins.
    Sensors and Actuators B Chemical 10/2013; 177:172–177. DOI:10.1016/j.snb.2012.10.117 · 3.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chemiluminescence, i.e. the emission of light from a chemical reaction, offers interesting opportunities for developing point-of-care biosensors. However, commercially available systems are expensive, bulky, and primarily addressed to laboratory usage. The goal of this paper is to present a novel work related to the design and experimental validation of a point-of-care device for cancer marker detection in human serum. The new system has been especially developed for cost-sensitive applications using only low-cost off-the-shelf components. The system was tested with blood serum. The output signal from spots with specific proteins uptake was two orders of magnitude higher than that from control spots: it was 14±3mV/s from the detection spots, while it was only 260μV/s and 242μV/s from the control spots.
    Sensors and Actuators B Chemical 06/2010; 147(2):475-480. DOI:10.1016/j.snb.2010.04.001 · 3.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper investigates technological advancements in developing reliable technologies for label free detection of cancer markers. Capacitance detection was used successfully to develop an immunosensor. Rigorous probe immobilization was implemented to obtain reliable capacitance measurements. The commonly considered alkanethiols for proteins immobilization do not allow sufficiently stable capacitance measurements. Therefore, new ethylene-glycol functionalized alkanethiols were used as more suitable materials to develop lab-on-a-chip detection of cancer markers. Results from AFM, Chemi-luminescence, Fluorescence, Cyclic Voltammetry, QCM, and capacitance measurements showed that three (ethylene-glycol) alkanethiols highly stabilized the sensing surfaces in time. The measured capacitance on the antibody layers was in the range of 60–70 nF/cm2 and 80–115 nF/cm2 for the antigen detection. The developed system was utilized to detect the Hepatocarcinoma marker SCCA, and the whole IgM fraction from Hepatocarcinoma patient’s serum. Electrode by electrode reproducibility within the same chip increased by one order of magnitude (variations were reduced from 30–40% down to less than 2%) using these new alkanethiols, while the reached limit in sensitivity was close to 2.43 μg/ml.
    Sensors and Actuators B Chemical 02/2009; DOI:10.1016/j.snb.2008.09.050 · 3.84 Impact Factor