Marrero Jorge A
University of Michigan, Ann Arbor, 48109, USA.
Curr Opin Gastroenterol. 2006 May;22(3):248-53. doi: 10.1097/01.mog.0000218961.86182.8c.
Our aim is to review the latest information regarding the risk factors, markers for early detection, diagnosis, and therapy for this tumor type.
Alcohol, tobacco, and obesity interact together to increase the risk of hepatocellular carcinoma, which may allow us to identify a high-risk group for hepatocellular carcinoma among patients with cirrhosis. For the first time, a randomized controlled trial of surveillance for hepatocellular carcinoma showed improved survival for those patients who underwent surveillance compared with no surveillance. Another study showed that washout of contrast of an arterially enhancing lesion is sensitive and specific for hepatocellular carcinoma. The Barcelona Clinic Liver Cancer staging classification is the best at stratifying prognosis and treatment strategy for patients with hepatocellular carcinoma. Three randomized trials showed that radiofrequency ablation improves survival when compared to percutaneous ethanol injection for early hepatocellular carcinoma.
Not all patients with cirrhosis have an equal risk for developing hepatocellular carcinoma. Further studies should stratify the risk of hepatocellular carcinoma so surveillance is tailored to those at the highest risk. Washout of contrast of arterially enhancing mass is regarded as the typical appearance of hepatocellular carcinoma in triple-phase imaging. Radiofrequency ablation is the best ablative technique for the treatment of small hepatocellular carcinoma.
我们的目的是回顾有关这种肿瘤类型的危险因素、早期检测标志物、诊断和治疗的最新信息。
酒精、烟草和肥胖相互作用会增加肝细胞癌的风险,这可能使我们能够在肝硬化患者中识别出肝细胞癌的高危人群。首次针对肝细胞癌监测的随机对照试验表明,与未接受监测的患者相比,接受监测的患者生存率有所提高。另一项研究表明,动脉期强化病变的造影剂廓清对肝细胞癌具有敏感性和特异性。巴塞罗那临床肝癌分期分类在对肝细胞癌患者的预后和治疗策略进行分层方面是最好的。三项随机试验表明,对于早期肝细胞癌,与经皮乙醇注射相比,射频消融可提高生存率。
并非所有肝硬化患者发生肝细胞癌的风险都相同。进一步的研究应分层肝细胞癌的风险,以便针对最高风险人群进行监测。动脉期强化肿块的造影剂廓清被视为三相成像中肝细胞癌的典型表现。射频消融是治疗小肝细胞癌的最佳消融技术。