Yıl: 2022 Cilt: 3 Sayı: 1 Sayfa Aralığı: 23 - 25 Metin Dili: İngilizce DOI: 10.14744/hf.2021.2021.0033 İndeks Tarihi: 12-05-2023

Prevention of hepatocellular carcinoma and monitoring of high-risk patients

Öz:
Hepatocellular carcinoma (HCC) accounts for some 80% of primary liver tumors. According to recent data, HCC is the sixth most common type of cancer and the third leading cause of cancer-related mortality worldwide. Risk factors for HCC include the presence of the hepatitis B virus, hepatitis C virus, non-alcoholic fatty liver disease, and exposure to noxious agents, such as alcohol, or toxins, such as aflatoxin, which are considered prevent- able etiologies of HCC. Monitoring strategies are needed for patients at risk of developing HCC. There is a consensus on routine monitoring of cirrhotic patients due to definitive evidence of a significantly high rate of progression to HCC; however, the appropriate surveillance of patients with advanced fibrosis remains a topic of discussion. Nevertheless, adherence to a strict observation protocol is the cornerstone of early detection and treatment with curative options for patients with a high risk of developing HCC. This review examines prevention strategies, risk factors, and surveillance based on current guidelines.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
  • 1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021 May;71(3):209-249.
  • 2. Baatarkhuu O, Gerelchimeg T, Munkh-Orshikh D, Batsukh B, Sarangua G, Amarsanaa J. Epidemiology, genotype distribution, prognosis, control, and management of viral hepatitis b, c, d, and hepatocellular carcinoma in mon- golia. Euroasian J Hepatogastroenterol 2018;8(1):57-62.
  • 3. Popp W, Gantumur T, Ross B, Zorigt K, Davaadorj D, Rossburg M, et al. Aflatoxin exposure may not play a role in liver cancer development in Mon- golia. Digestion 2014;89(4):268-71.
  • 4. Valery PC, Laversanne M, Clark PJ, Petrick JL, McGlynn KA, Bray F. Pro- jections of primary liver cancer to 2030 in 30 countries worldwide. Hepatol- ogy 2018;67(2):600-611.
  • 5. Petrick JL, Florio AA, Znaor A, Ruggieri D, Laversanne M, Alvarez CS, et al. International trends in hepatocellular carcinoma incidence, 1978-2012. Int J Cancer. 2020;147(2):317-330.
  • 6. Liu Z, Xu K, Jiang Y, Cai N, Fan J, Mao X, et al. Global trend of aetiolo- gy-based primary liver cancer incidence from 1990 to 2030: a modelling study. Int J Epidemiol. 2021;50(1):128-142.
  • 7. Seyda Seydel G, Kucukoglu O, Demir OO, Yilmaz S, Akkiz H, et al. Eco- nomic growth leads to increase of obesity and associated hepatocellular car- cinoma in developing countries. Ann Hepatol 2016;15(5):662-672.
  • 8. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contribu- tions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;45(4):529-538.
  • 9. Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health 2016;4(9):e609-e616.
  • 10. Chiang CJ, Yang YW, You SL, Lai MS, Chen CJ. Thirty-year outcomes of the national hepatitis B immunization program in Taiwan. JAMA 2013;310(9):974-976.
  • 11. Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, et al. Evaluation of the im- pact of hepatitis B vaccination among children born during 1992-2005 in China. J Infect Dis 2009;200(1):39-47.
  • 12. Ang LW, Cutter J, James L, Goh KT. Seroepidemiology of hepatitis B virus infection among adults in Singapore: a 12-year review. Vaccine 2013;32(1):103-110.
  • 13. World Health Organization. Immunization coverage. Available at: https:// www.who.int/news-room/fact-sheets/detail/immunization-coverage. Ac- cessed on July 31, 2021.
  • 14. World Health Organization. WHO-UNICEF estimates of HepB3 coverage. In: World Health Organization. Available at: http://apps.who.int/immuniza- tion_monitoring/globalsummary/timeseries/tswucoveragehepb3.html. Ac- cessed on July 31, 2021
  • 15. Miyahara R, Jasseh M, Gomez P, Shimakawa Y, Greenwood B, Keita K, et al. Barriers to timely administration of birth dose vaccines in The Gambia, West Africa. Vaccine 2016;34(29):3335-3341.
  • 16. Pley CM, McNaughton AL, Matthews PC, Lourenço J. The global impact of the COVID-19 pandemic on the prevention, diagnosis and treatment of hepatitis B virus (HBV) infection. BMJ Glob Health 2021;6(1):e004275.
  • 17. Jourdain G, Ngo-Giang-Huong N, Harrison L, Khamduang W, Tierney C, Salvadori N, et al. Tenofovir versus placebo to prevent perinatal transmis- sion of hepatitis B. N Engl J Med. 2018;378(10):911-923.
  • 18. Gamkrelidze I, Pawlotsky JM, Lazarus JV, Feld JJ, Zeuzem S, Bao Y, et al. Progress towards hepatitis C virus elimination in high-income countries: An updated analysis. Liver Int 2021;41(3):456-463.
  • 19. Razavi H, Gonzalez YS, Yuen C, Cornberg M. Global timing of hepatitis C virus elimination in high-income countries. Liver Int 2020;40(3):522-529.
  • 20. Kondili LA, Craxì A, Aghemo A. Absolute targets for HCV elimination and national health policy paradigms: Foreseeing future requirements. Liver Int 2021;41(4):649-655.
  • 21. Kardani K, Sadat SM, Kardani M, Bolhassani A. The next generation of HCV vaccines: a focus on novel adjuvant development. Expert Rev Vac- cines 2021;20(7):839-855.
  • 22. Chhatwal J, Kanwal F, Roberts MS, Dunn MA. Cost-effectiveness and bud- get impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States. Ann Intern Med 2015;162(6):397-406.
  • 23. Kanwal F, Kramer JR, Asch SM, Cao Y, Li L, El-Serag HB. Long-Term Risk of hepatocellular carcinoma in hcv patients treated with direct acting antiviral agents. Hepatology 2020;71(1):44-55.
  • 24. World Health Organization. Global Health Sector Strategy on Viral Hepa- titis2016-2021. Towards Ending Viral Hepatitis. Available at: https://apps. who.int/iris/bitstream/handle/10665/246177/WHO-HIV-2016.06-eng.pd- f?sequence=1. Accessed on August 1, 2021.
  • 25. Ghany MG, Morgan TR; AASLD-IDSA Hepatitis C Guidance Panel. Hep- atitis C Guidance 2019 Update: American Association for the Study of Liv- er Diseases-Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection. Hepatology 2020;71(2):686-721.
  • 26. Sulkowski M, Cheng WH, Marx S, Sanchez Gonzalez Y, Strezewski J, Reau N. Estimating the year each state in the United States will achieve the world health organization’s elimination targets for hepatitis C. Adv Ther 2021;38(1):423-440.
  • 27. Epstein RL, Sabharwal V, Wachman EM, Saia KA, Vellozzi C, Hariri S, et al. Perinatal transmission of hepatitis C virus: defining the cascade of care. J Pediatr. 2018;203:34-40.e1.
  • 28. McGlynn KA, Petrick JL, London WT. Global epidemiology of hepatocel- lular carcinoma: an emphasis on demographic and regional variability. Clin Liver Dis 2015;19(2):223-238.
  • 29. Strosnider H, Azziz-Baumgartner E, Banziger M, Bhat RV, Breiman R, Brune MN, et al. Workgroup report: public health strategies for reduc- ing aflatoxin exposure in developing countries. Environ Health Perspect. 2006;114(12):1898-1903.
  • 30. Chen JG, Egner PA, Ng D, Jacobson LP, Muñoz A, Zhu YR, et al. Reduced aflatoxin exposure presages decline in liver cancer mortality in an endemic region of China. Cancer Prev Res (Phila) 2013;6(10):1038-1045.
  • 31. Younossi Z, Tacke F, Arrese M, Chander Sharma B, Mostafa I, Bugianesi E, et al. Global perspectives on nonalcoholic fatty liver disease and nonalco- holic steatohepatitis. Hepatology 2019;69(6):2672-2682.
  • 32. Dai W, Ye L, Liu A, Wen SW, Deng J, Wu X, et al. Prevalence of nonal- coholic fatty liver disease in patients with type 2 diabetes mellitus: A me- ta-analysis. Medicine (Baltimore) 2017;96(39):e8179.
  • 33. Li L, Liu DW, Yan HY, Wang ZY, Zhao SH, Wang B. Obesity is an inde- pendent risk factor for non-alcoholic fatty liver disease: evidence from a meta-analysis of 21 cohort studies. Obes Rev 2016;17(6):510-519.
  • 34. Yilmaz Y, Younossi ZM. Obesity-associated nonalcoholic fatty liver dis- ease. Clin Liver Dis 2014;18(1):19-31.
  • 35. Kaya E, Yilmaz Y. Non-alcoholic Fatty Liver Disease: A Global Public Health Issue. In: Faintuch J, Faintuch S, editors. Obesity and Diabetes. New York: Springer, Cham; 2020. pp. 321-333.
  • 36. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Glob- al epidemiology of nonalcoholic fatty liver disease-Meta-analytic assess- ment of prevalence, incidence, and outcomes. Hepatology 2016;64(1):73- 84.
  • 37. Wong RJ, Cheung R, Ahmed A. Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepato- cellular carcinoma in the U.S. Hepatology 2014;59(6):2188-2195.
  • 38. Goldberg D, Ditah IC, Saeian K, Lalehzari M, Aronsohn A, Gorospe EC, et al. Changes in the prevalence of hepatitis C virus infection, nonalcohol- ic steatohepatitis, and alcoholic liver disease among patients with cirrhosis or liver failure on the waitlist for liver transplantation. Gastroenterology 2017;152(5):1090-1099.e1.
  • 39. Ertle J, Dechêne A, Sowa JP, Penndorf V, Herzer K, Kaiser G, et al. Non-al- coholic fatty liver disease progresses to hepatocellular carcinoma in the ab- sence of apparent cirrhosis. Int J Cancer 2011;128(10):2436-2443.
  • 40. Canbay A, Kachru N, Haas JS, Meise D, Ozbay AB, Sowa JP. Healthcare re- source utilization and costs among nonalcoholic fatty liver disease patients in Germany. Ann Transl Med 2021;9:615.
  • 41. Brunner KT, Henneberg CJ, Wilechansky RM, Long MT. Nonalcoholic Fat- ty Liver Disease and Obesity Treatment. Curr Obes Rep 2019;8(3):220-228.
  • 42. Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, Torres-Gonzalez A, Gra-Oramas B, Gonzalez-Fabian L, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology 2015;149(2):367-378.e5; quiz e14-5.
  • 43. Ramai D, Singh J, Lester J, Khan SR, Chandan S, Tartaglia N, et al. Sys- tematic review with meta-analysis: bariatric surgery reduces the incidence of hepatocellular carcinoma. Aliment Pharmacol Ther 2021;53(9):977-984.
  • 44. Kennedy OJ, Roderick P, Buchanan R, Fallowfield JA, Hayes PC, Parkes J. Coffee, including caffeinated and decaffeinated coffee, and the risk of hepa- tocellular carcinoma: a systematic review and dose-response meta-analysis. BMJ Open 2017;7(5):e013739.
  • 45. Alexander M, Loomis AK, van der Lei J, Duarte-Salles T, Prieto-Alhambra D, Ansell D, et al. Risks and clinical predictors of cirrhosis and hepatocellu- lar carcinoma diagnoses in adults with diagnosed NAFLD: real-world study of 18 million patients in four European cohorts. BMC Med 2019;17(1):95.
  • 46. Canbay A, Kachru N, Haas JS, Sowa JP, Meise D, Ozbay AB. Patterns and predictors of mortality and disease progression among patients with non-al- coholic fatty liver disease. Aliment Pharmacol Ther 2020;52(7):1185-1194.
  • 47. Yang JD, Ahmed F, Mara KC, Addissie BD, Allen AM, Gores GJ, et al. Diabetes is associated with increased risk of hepatocellular carcinoma in patients with cirrhosis from nonalcoholic fatty liver disease. Hepatology 2020;71(3):907-916.
  • 48. Franciosi M, Lucisano G, Lapice E, Strippoli GF, Pellegrini F, Nicolucci A. Metformin therapy and risk of cancer in patients with type 2 diabetes: systematic review. PloS One 2013;8(8):e71583.
  • 49. Singh S, Singh PP, Singh AG, Murad MH, McWilliams RR, Chari ST. An- ti-diabetic medications and risk of pancreatic cancer in patients with dia- betes mellitus: a systematic review and meta-analysis. Am J Gastroenterol 2013;108(4):510-519. quiz 520.
  • 50. Zhang H, Gao C, Fang L, Zhao HC, Yao SK. Metformin and reduced risk of hepatocellular carcinoma in diabetic patients: a meta-analysis. Scand J Gastroenterol 2013;48(1):78-87.
  • 51. Goh MJ, Sinn DH, Kim S, Woo SY, Cho H, Kang W, et al. Statin use and the risk of hepatocellular carcinoma in patients with chronic hepatitis B. Hepatology. 2020;71(6):2023-2032.
  • 52. Facciorusso A, Abd El Aziz MA, Singh S, Pusceddu S, Milione M, Gia- comelli L, et al. Statin use decreases the incidence of hepatocellular carci- noma: an updated meta-analysis. Cancers (Basel). 2020;12(4):874.
  • 53. Simon TG, Ma Y, Ludvigsson JF, Chong DQ, Chong DQ, Giovannucci EL, et al. Association between aspirin use and risk of hepatocellular carcinoma. JAMA Oncol 2018;4(12):1683-1690.
  • 54. Purohit V, Rapaka R, Kwon OS, Song BJ. Roles of alcohol and tobac- co exposure in the development of hepatocellular carcinoma. Life Sci. 2013;92(1):3-9.
  • 55. West J, Card TR, Aithal GP, Fleming KM. Risk of hepatocellular carci- noma among individuals with different aetiologies of cirrhosis: a popula- tion-based cohort study. Aliment Pharmacol Ther 2017;45(7):983-990.
  • 56. World Cancer Research Fund Network. Diet, nutrition, physical activ- ity and liver cancer. Available at: https://www.wcrf.org/wp-content/up- loads/2021/02/liver-cancer-report.pdf. Accessed on August 1, 2021.
  • 57. Petrick JL, Campbell PT, Koshiol J, Thistle JE, Andreotti G, Beane-Free- man LE, et al. Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project. Br J Cancer 2018;118(7):1005-1012.
  • 58. Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Al- cohol consumption and site-specific cancer risk: a comprehensive dose-re- sponse meta-analysis. Br J Cancer 2015;112(3):580-93.
  • 59. Loomba R, Yang HI, Su J, Brenner D, Barrett-Connor E, Iloeje U, et al. Syn- ergism between obesity and alcohol in increasing the risk of hepatocellular carcinoma: a prospective cohort study. Am J Epidemiol 2013;177(4):333-342.
  • 60. Tamura T, Wada K, Konishi K, Goto Y, Mizuta F, Koda S, et al. Coffee, green tea, and caffeine intake and liver cancer risk: a prospective cohort study. Nutr Cancer 2018;70:1210-1216.
  • 61. Kennedy OJ, Roderick P, Buchanan R, Fallowfield JA, Hayes PC, Parkes J. Coffee, including caffeinated and decaffeinated coffee, and the risk of hepa- tocellular carcinoma: a systematic review and dose-response meta-analysis. BMJ Open 2017;7(5):e013739.
  • 62. Di Maso M, Boffetta P, Negri E, La Vecchia C, Bravi F. Caffeinated cof- fee consumption and health outcomes in the us population: a dose-response meta-analysis and estimation of disease cases and deaths avoided. Adv Nutr 2021;12(4):1160-1176.
  • 63. Bravi F, Tavani A, Bosetti C, Boffetta P, La Vecchia C. Coffee and the risk of hepatocellular carcinoma and chronic liver disease: a systematic review and meta-analysis of prospective studies. Eur J Cancer Prev 2017;26(5):368-377.
  • 64. European Association for the Study of the Liver. Electronic address: easlof- fice@easloffice.eu; European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of hepatocellular carcinoma. J Hepatol 2018;69(1):182-236.
  • 65. Bruix J, Sherman M; American Association for the Study of Liver Dis- eases. Management of hepatocellular carcinoma: an update. Hepatology 2011;53(3):1020-1022.
  • 66. Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int 2017;11(4):317-370.
  • 67. Vogel A, Cervantes A, Chau I, Daniele B, Llovet JM, Meyer T, et al. He- patocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018;29(Suppl 4):iv238-iv255.
  • 68. Chen LT, Martinelli E, Cheng AL, Pentheroudakis G, Qin S, Bhattacharyya GS, et al. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with intermediate and advanced/relapsed hepato- cellular carcinoma: a TOS-ESMO initiative endorsed by CSCO, ISMPO, JSMO, KSMO, MOS and SSO. Ann Oncol 2020;31(3):334-351.
  • 69. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011;53(3):1020-1022.
  • 70. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Go- mez M, et al. A new definition for metabolic dysfunction-associated fat- ty liver disease: an international expert consensus statement. J Hepatol 2020;73(1):202-209.
  • 71. Eslam M, Sarin SK, Wong VW, Fan JG, Kawaguchi T, Ahn SH, et al. The Asian Pacific Association for the Study of the Liver clinical practice guide- lines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int 2020;14(6):889-919.
  • 72. Kim JH, Kang SH, Lee M, Choi HS, Jun BG, Kim TS, et al. Individual- ized surveillance of chronic hepatitis B patients according to hepatocellu- lar carcinoma risk based on PAGE-B scores. Eur J Gastroenterol Hepatol 2021;33(12):1564-1572.
  • 73. Santi V, Trevisani F, Gramenzi A, Grignaschi A, Mirici-Cappa F, Del Poggio P, et al. Semiannual surveillance is superior to annual surveillance for the detection of early hepatocellular carcinoma and patient survival. J Hepatol 2010;53(2):291-297.
  • 74. Singal A, Volk ML, Waljee A, Salgia R, Higgins P, Rogers MA, et al. Me- ta-analysis: surveillance with ultrasound for early-stage hepatocellular car- cinoma in patients with cirrhosis. Aliment Pharmacol Ther 2009;30(1):37- 47.
  • 75. Tzartzeva K, Obi J, Rich NE, Parikh ND, Marrero JA, Yopp A, et al. Sur- veillance imaging and alpha fetoprotein for early detection of hepatocellu- lar carcinoma in patients with cirrhosis: a meta-analysis. Gastroenterology 2018;154(6):1706-1718.e1.
  • 76. Johnson PJ, Pirrie SJ, Cox TF, Berhane S, Teng M, Palmer D, et al. The detection of hepatocellular carcinoma using a prospectively developed and validated model based on serological biomarkers. Cancer Epidemiol Bio- markers Prev 2014;23(1):144-153.
  • 77. Best J, Bechmann LP, Sowa JP, Sydor S, Dechêne A, Pflanz K, et al. GALAD score detects early hepatocellular carcinoma in an international cohort of patients with nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2020;18(3):728-735.e4.
  • 78. Mehta N, Parikh ND, Kelley RK, Hameed B, Singal AG. Surveillance and Monitoring of Hepatocellular Carcinoma During the COVID-19 Pandemic. Clin Gastroenterol Hepatol 2021;19(8):1520-1530.
  • 79. Schotten C, Ostertag B, Sowa J-P, Manka P, Bechmann LP, Hilgard G, et al. GALAD score detects early-stage hepatocellular carcinoma in a euro- pean cohort of chronic hepatitis B and C patients. Pharmaceuticals (Basel) 2021;14(8):735.
  • 80. Petta S, Sebastiani G, Viganò M, Ampuero J, Wai-Sun Wong V, et al. Mon- itoring occurrence of liver-related events and survival by transient elastog- raphy in patients with nonalcoholic fatty liver disease and compensated advanced chronic liver disease. Clin Gastroenterol Hepatol 2021;19(4):806- 815.e5.
  • 81. Oh JH, Goh MJ, Park Y, Kim J, Kang W, Sinn DH, et al. Different perfor- mance of liver stiffness measurement according to etiology and outcome for the prediction of liver-related events. Dig Dis Sci 2021;66(8):2816-2825.
  • 82. Wang J, Shan Q, Liu Y, Yang H, Kuang S, He B, et al. 3D MR Elastography of hepatocellular carcinomas as a potential biomarker for predicting tumor recurrence. J Magn Reson Imaging 2019;49(3):719-730.
  • 83. Cho HJ, Kim B, Kim HJ, Huh J, Kim JK, Lee JH, et al. Liver stiffness measured by MR elastography is a predictor of early HCC recurrence after treatment. Eur Radiol 2020;30(8):4182-4192.
APA Kaya E, MAZZOLINI G, Yilmaz Y, Canbay A (2022). Prevention of hepatocellular carcinoma and monitoring of high-risk patients. , 23 - 25. 10.14744/hf.2021.2021.0033
Chicago Kaya Eda,MAZZOLINI GUILLERMO,Yilmaz Yusuf,Canbay Ali Prevention of hepatocellular carcinoma and monitoring of high-risk patients. (2022): 23 - 25. 10.14744/hf.2021.2021.0033
MLA Kaya Eda,MAZZOLINI GUILLERMO,Yilmaz Yusuf,Canbay Ali Prevention of hepatocellular carcinoma and monitoring of high-risk patients. , 2022, ss.23 - 25. 10.14744/hf.2021.2021.0033
AMA Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A Prevention of hepatocellular carcinoma and monitoring of high-risk patients. . 2022; 23 - 25. 10.14744/hf.2021.2021.0033
Vancouver Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A Prevention of hepatocellular carcinoma and monitoring of high-risk patients. . 2022; 23 - 25. 10.14744/hf.2021.2021.0033
IEEE Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A "Prevention of hepatocellular carcinoma and monitoring of high-risk patients." , ss.23 - 25, 2022. 10.14744/hf.2021.2021.0033
ISNAD Kaya, Eda vd. "Prevention of hepatocellular carcinoma and monitoring of high-risk patients". (2022), 23-25. https://doi.org/10.14744/hf.2021.2021.0033
APA Kaya E, MAZZOLINI G, Yilmaz Y, Canbay A (2022). Prevention of hepatocellular carcinoma and monitoring of high-risk patients. Hepatology forum, 3(1), 23 - 25. 10.14744/hf.2021.2021.0033
Chicago Kaya Eda,MAZZOLINI GUILLERMO,Yilmaz Yusuf,Canbay Ali Prevention of hepatocellular carcinoma and monitoring of high-risk patients. Hepatology forum 3, no.1 (2022): 23 - 25. 10.14744/hf.2021.2021.0033
MLA Kaya Eda,MAZZOLINI GUILLERMO,Yilmaz Yusuf,Canbay Ali Prevention of hepatocellular carcinoma and monitoring of high-risk patients. Hepatology forum, vol.3, no.1, 2022, ss.23 - 25. 10.14744/hf.2021.2021.0033
AMA Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A Prevention of hepatocellular carcinoma and monitoring of high-risk patients. Hepatology forum. 2022; 3(1): 23 - 25. 10.14744/hf.2021.2021.0033
Vancouver Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A Prevention of hepatocellular carcinoma and monitoring of high-risk patients. Hepatology forum. 2022; 3(1): 23 - 25. 10.14744/hf.2021.2021.0033
IEEE Kaya E,MAZZOLINI G,Yilmaz Y,Canbay A "Prevention of hepatocellular carcinoma and monitoring of high-risk patients." Hepatology forum, 3, ss.23 - 25, 2022. 10.14744/hf.2021.2021.0033
ISNAD Kaya, Eda vd. "Prevention of hepatocellular carcinoma and monitoring of high-risk patients". Hepatology forum 3/1 (2022), 23-25. https://doi.org/10.14744/hf.2021.2021.0033