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Challenges of liver cancer: Future emerging tools in imaging and urinary biomarkers.

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Title: Challenges of liver cancer: Future emerging tools in imaging and urinary biomarkers.
Authors: Trovato, FM
Tognarelli, JM
Crossey, MM
Catalano, D
Taylor-Robinson, SD
Trovato, GM
Item Type: Journal Article
Abstract: © The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.Chronic liver disease has become a global health problem as a result of the increasing incidence of viral hepatitis, obesity and alcohol misuse. Over the past three decades, in the United Kingdom alone, deaths from chronic liver disease have increased both in men and in women. Currently, 2.5% of deaths worldwide are attributed to liver disease and projected figures suggest a doubling in hospitalisation and associated mortality by 2020. Chronic liver diseases vary for clinical manifestations and natural history, with some individuals having relatively indolent disease and others with a rapidly progressive course. About 30% of patients affected by hepatitis C has a progressive disease and develop cirrhosis over a 20 years period from the infection, usually 5-10 years after initial medical presentation. The aim of the current therapeutic strategies is preventing the progression from hepatitis to fibrosis and subsequently, cirrhosis. Hepatic steatosis is a risk factor for chronic liver disease and is affecting about the half of patients who abuse alcohol. Moreover non-alcoholic fatty liver disease is part of the metabolic syndrome, associated with obesity, hypertension, type ? diabetes mellitus and dyslipidaemia, and a subgroup of patients develops non-alcoholic steatohepatitis and fibrosis with subsequent cirrhosis. The strengths and pitfalls of liver biopsy are discussed and a variety of new techniques to assess liver damage from transient elastography to experimental techniques, such as in vitro urinary nuclear magnetic resonance spectroscopy. Some of the techniques and tests described are already suitable for more widespread clinical application, as is the case with ultrasound-based liver diagnostics, but others, such as urinary metabonomics, requires a period of critical evaluation or development to take them from the research arena to clinical practice.
Issue Date: 18-Nov-2015
Date of Acceptance: 23-Oct-2015
URI: http://hdl.handle.net/10044/1/28673
DOI: https://dx.doi.org/10.4254/wjh.v7.i26.2664
ISSN: 1948-5182
Publisher: Baishideng Publishing Group Co. Limited
Start Page: 2664
End Page: 2675
Journal / Book Title: World Journal of Hepatology
Volume: 7
Issue: 26
Copyright Statement: ©The Author(s) 2015. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sponsor/Funder: Imperial College Healthcare Charity
Trustees of the London Clinic
Imperial College Healthcare Charity
Medical Research Council (MRC)
Funder's Grant Number: DMAHE_P20112
Keywords: Fibrosis
Liver cancer
Urinary biomarkers
Virus hepatitis
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer