Morgan Timothy R
Gastroenterology Section, VA Long Beach Healthcare System, Long Beach, CA 90822, USA.
Recent Results Cancer Res. 2011;188:85-99. doi: 10.1007/978-3-642-10858-7_7.
Hepatitis C virus (HCV) infection causes chronic hepatitis, which can progress to cirrhosis and hepatocellular carcinoma (HCC). The incidence of hepatocellular carcinoma in the United States tripled between 1975 and 2005, and is expected to increase further, and to remain elevated for more than 20 years. Curing hepatitis C infection in patients with cirrhosis through treatment with peginterferon and ribavirin reduces the risk of developing hepatocellular carcinoma. Several noncurative treatments also appear to reduce the risk of hepatocellular carcinoma in patients with chronic hepatitis C. Prospective studies report a reduced incidence of hepatocellular carcinoma among patients treated with a mixture of carotenoids with or without myo-inositol, with vitamin K₂, or with polyprenoic acid (an acyclic retinoid). Uncontrolled and/or retrospective studies have reported beneficial effects of treatment with Sho-saiko-to, glycyrrhizin and ursodeoxycholic acid on hepatocellular carcinoma incidence. Meta-analyses of epidemiologic studies show a reduced risk of hepatocellular carcinoma among liver disease patients who drink two or more cups of coffee per day. Numerous agents prevent or reduce hepatocarcinogenesis in animal models. An ongoing Phase II clinical trial is evaluating S-adenosylmethionine (SAMe) as a potential chemopreventive agent in hepatitis C cirrhosis. Overall, these data suggest that chemoprevention of hepatocellular carcinoma in patients with chronic hepatitis C is an achievable objective.
丙型肝炎病毒（HCV）感染可导致慢性肝炎，进而发展为肝硬化和肝细胞癌（HCC）。1975年至2005年间，美国肝细胞癌的发病率增长了两倍，预计还会进一步上升，并在20多年内居高不下。通过聚乙二醇干扰素和利巴韦林治疗治愈丙型肝炎感染的肝硬化患者，可降低发生肝细胞癌的风险。几种非治愈性治疗方法似乎也能降低慢性丙型肝炎患者发生肝细胞癌的风险。前瞻性研究报告称，接受类胡萝卜素与或不与肌醇、维生素K₂或多聚戊烯酸（一种无环视黄醛）混合治疗的患者中，肝细胞癌的发病率有所降低。非对照和/或回顾性研究报告了小柴胡汤、甘草酸和熊去氧胆酸治疗对肝细胞癌发病率的有益影响。流行病学研究的荟萃分析表明，每天饮用两杯或更多咖啡的肝病患者发生肝细胞癌的风险降低。许多药物在动物模型中可预防或减少肝癌发生。一项正在进行的II期临床试验正在评估S-腺苷甲硫氨酸（SAMe）作为丙型肝炎肝硬化潜在化学预防剂的效果。总体而言，这些数据表明，对慢性丙型肝炎患者进行肝细胞癌的化学预防是一个可以实现的目标。
