Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide with a high rate of mortality and an increasing incidence. The most common causes of HCC are either a viral hepatitis infection (hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis).
The starting point in the diagnostic surveillance of at risk patients is ultrasound. In a second stage this can be completed with the measurement of a tumor marker called α-fetoprotein (AFP). Since ultrasound has a poor performance in cirrhotic patients and is also operator dependent, further characterization by CT or MRI is often required.
As it is important to detect HCC at an early stage when the disease is still curable, biomarkers can complete the diagnosis obtained with ultrasound before moving on to the more expensive MRI. Biomarkers can also be used to better stratify patients on the liver transplant waiting list. Additionally, the risk of recurrence of HCC after transplantation can be assessed by monitoring patients with biomarkers.