Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Dig Dis. 2010;28(4-5):596-9. doi: 10.1159/000320057. Epub 2010 Nov 18.
Liver cancer is a major global health problem and hepatocellular carcinoma (HCC) accounts for 75% of all liver carcinoma. HCC occurs more often in men than in women and mostly in people 50 to 60 years old. The disease is more common in parts of sub-Saharan Africa and Asia than in North and South America and Europe. Nevertheless its incidence increased over the past 4 decades in some Western countries. Worldwide, liver carcinoma is the 5th most common cancer and 3rd most common cause of cancer mortality (behind only lung and colorectal cancer) with approximately 680,000 annual deaths. Unlike most of the other malignancies, HCC almost entirely develops in the context of inflammation and organ injury and is related to cirrhosis in about 85% of the cases. Among underlying etiologies of liver cirrhosis, most frequent are viral infection and toxic substances, mostly alcohol. The main HCC risk factor in Eastern Asia and Africa is hepatitis B virus infection. Hepatitis C virus infection is the main risk factor in Western countries. Hereditary hemochromatosis is not a very frequent cause of liver cirrhosis, but these patients are at higher risk for HCC compared with other etiologies of cirrhosis. Aflatoxins, cancer-causing substances made by a type of plant mold, can play a role in some countries in Asia and Africa, and can have a synergistic effect with hepatitis B infection.
肝癌是一个全球性的重大健康问题，其中肝细胞癌（HCC）占所有肝癌的 75%。HCC 更常见于男性，且多发生于 50 至 60 岁人群。这种疾病在撒哈拉以南非洲和亚洲的发病率高于北美和南美以及欧洲。尽管如此，在过去的 40 年中，一些西方国家的发病率有所上升。在全球范围内，肝癌是第 5 大常见癌症，也是第 3 大癌症死亡原因（仅次于肺癌和结直肠癌），每年约有 68 万人死亡。与大多数其他恶性肿瘤不同，HCC 几乎完全在炎症和器官损伤的背景下发展，约 85%的病例与肝硬化有关。在肝硬化的潜在病因中，最常见的是病毒感染和有毒物质，主要是酒精。在东亚和非洲，HCC 的主要危险因素是乙型肝炎病毒感染。在西方国家，丙型肝炎病毒感染是主要的危险因素。遗传性血色素沉着症不是肝硬化的常见病因，但与其他病因引起的肝硬化相比，这些患者 HCC 的风险更高。黄曲霉毒素是一种植物霉菌产生的致癌物质，在亚洲和非洲的一些国家可能会发挥作用，并与乙型肝炎感染有协同作用。
