Bruno Raffaele, Puoti Massimo, Sacchi Paolo, Filice Carlo, Carosi Giampiero, Filice Gaetano
Division of Infectious and Tropical Diseases, IRCCS San Matteo Hospital, University of Pavia, Pavia, Italy.
J Hepatol. 2006;44(1 Suppl):S146-50. doi: 10.1016/j.jhep.2005.11.029. Epub 2005 Dec 1.
Hepatocellular carcinoma (HCC) resulting from chronic infection with hepatitis B or C virus (HBV, HCV) is a significant health problem. Concurrent infection with human immunodeficiency virus (HIV) may accelerate the progression from cirrhosis to HCC. Current guidelines advise screening patients with cirrhosis at 6-month intervals using ultrasonography and measurement of alpha-fetoprotein levels. In early-stage HCC, resection and liver transplantation are curative, as is percutaneous ethanol injection for small tumours in patients who are not candidates for surgery. HIV-infected patients do not qualify for liver transplantation. For late-stage HCC, chemoembolization can improve survival. Prevention of hepatitis and cirrhosis are key goals in reducing the impact of HCC. Numerous issues in HCC prevention, diagnosis, and management still remain to be resolved through large-scale, randomized clinical trials.
由乙型或丙型肝炎病毒（HBV、HCV）慢性感染导致的肝细胞癌（HCC）是一个重大的健康问题。同时感染人类免疫缺陷病毒（HIV）可能会加速从肝硬化发展为HCC的进程。目前的指南建议，对肝硬化患者每隔6个月进行一次超声检查并检测甲胎蛋白水平以进行筛查。在HCC早期，手术切除和肝移植可治愈疾病，对于不适合手术的小肿瘤患者，经皮乙醇注射也是一种治疗方法。HIV感染患者不符合肝移植条件。对于晚期HCC，化疗栓塞可提高生存率。预防肝炎和肝硬化是减轻HCC影响的关键目标。HCC预防、诊断和管理中的许多问题仍有待通过大规模随机临床试验来解决。
