Blum H E, Hopt U T
Abteilung Innere Medizin II, Medizinische Universitätsklinik, Freiburg.
Chirurg. 2003 Aug;74(8):709-16. doi: 10.1007/s00104-003-0713-8.
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world, with an extremely poor prognosis. The clinical and molecular pathogenesis of HCC is very complex and involves alterations in the structure or expression of several tumor suppressor genes, oncogenes and, possibly, mechanisms leading to genetic instability due to mismatch repair deficiency or chromosomal instability and aneuploidy due to defective chromosomal segregation. Central to the molecular pathogenesis of HCC are mutations of various genes and a genetic instability which, in most cases, result from chronic liver disease and the associated enhanced liver cell regeneration and mitotic activity. The prognosis is generally very poor. Most studies report a 5-year survival rate of less than 5% in symptomatic HCC patients. Therapeutic strategies include resection, liver transplantation, and nonsurgical interventions such as percutaneous ethanol injection, radiofrequency thermal ablation, transarterial embolization, and chemoembolization. HCC has been shown to be quite resistant to radio- and chemotherapy.
肝细胞癌（HCC）是世界上某些地区最常见的恶性肿瘤之一，预后极差。HCC的临床和分子发病机制非常复杂，涉及多个肿瘤抑制基因、癌基因的结构或表达改变，以及可能由于错配修复缺陷导致的遗传不稳定机制，或由于染色体分离缺陷导致的染色体不稳定和非整倍体。HCC分子发病机制的核心是各种基因的突变和遗传不稳定，在大多数情况下，这是由慢性肝病以及相关的增强的肝细胞再生和有丝分裂活动引起的。预后通常非常差。大多数研究报告称，有症状的HCC患者5年生存率低于5%。治疗策略包括手术切除、肝移植以及非手术干预，如经皮乙醇注射、射频热消融、经动脉栓塞和化疗栓塞。HCC已被证明对放疗和化疗相当耐药。
