Cilj ovoga preglednog rada je upoznati liječnika obiteljske medicine (LOM) s novostima u načinima probira, dijagnosticiranja, praćenja i liječenja oboljelih od hepatocelularnog karcinoma (HCC), najčešće primarne maligne bolesti jetre. Prikazani su epidemiologija, etiologija, klinička slika, dijagnostika te maligne bolesti, ukazano je na porast incidencije koji se prati i u Republici Hrvatskoj, u kojoj su hepatitis B i C i nadalje važan javnozdravstveni problem. Navedene su smjernice nekoliko stručnih društava za dijagnostiku HCC-a koja se zasniva na tipičnom slikovnom prikazu CT-om ili MR te biopsijom. Posebno je obrađeno praćenje visokorizične populacije uz navod da je prema NCCN najprikladniji test za praćenje osoba s visokim rizikom uz ultrazvučnu pretragu jetre i određivanje alfa fetoproteina. Detaljno je opisano stupnjevanje i prognoza HCC-a uz navod da su
glavne prognostičke varijable stadij tumora, funkcija jetre i ukupno stanje pacijenta. Istaknuta je uloga LOM-a kao osobe prvog kontakta u prevenciji HCC-a prepoznavanjem, probirom i praćenjem visokorizičnih pojedinaca, posebno intravenskih ovisnika o drogama koje treba testirati na prisutnost anti HCV protutijela i na HBsAg.Hepatocellular carcinoma (HCC) is the most common malignancy of the liver, the sixth most common cause of cancer and the third leading cause of cancer-related deaths worldwide. Its incidence has increased dramatically throughout the world mainly driven by the increasing numbers of persons with long-standing chronic hepatitis C virus (HCV) infection who develop cirrhosis. Although 90% of HCV-associated HCC cases occur concurrently with cirrhosis, 30% to 50% of liver cancers associated with chronic HBV occur in the absence of cirrhosis. Since most people with chronic hepatitis are asymptomatic until cirrhosis or HCC is established, initial diagnosis and management of chronic hepatitis rely on primary care physicians to identify and screen high risk individuals. Studies show that family physicians have inadequate knowledge about screening and counseling for chronic hepatitis and HCC. There is evidence of advances in surgical and nonsurgical therapies in the treatment of HCC, thus different associations have updated their recommendations following these clinical and scientifi c advances. The aim of this review is to make family physicians familiar with novelties in identifying high-risk patients, implementing an appropriate screening strategy, diagnosis and treatment, and to assist them in the decision-making process according to evidence based data
