肝硬化小肝细胞癌的管理：重点关注门静脉高压症。
Management of small hepatocellular carcinoma in cirrhosis: focus on portal hypertension.
机构信息
Hepatocellular Carcinoma Translational Research Laboratory, Barcelona-Clinic Liver Cancer Group, Institut d'Investigacions Biomediques August Pi i Sunyer, Liver Unit, Hospital Clinic, 08036 Barcelona, Spain.
出版信息
World J Gastroenterol. 2013 Feb 28;19(8):1193-9. doi: 10.3748/wjg.v19.i8.1193.
Abstract
The incidence of hepatocellular carcinoma (HCC) is rising worldwide being currently the fifth most common cancer and third cause of cancer-related mortality. Early detection of HCC through surveillance programs have enabled the identification of small nodules with higher frequency, and nowadays account for 10%-15% of patients diagnosed in the West and almost 30% in Japan. Patients with small HCC can be candidates for potential curative treatments: liver transplantation, surgical resection and percutaneous ablation, depending on the presence of portal hypertension and co-morbidities. This review will analyze recent advancements in the clinical management of these individuals, focusing on issues related to the role of portal hypertension, the debate between resection and ablative therapies and the future impact of molecular technologies.
摘要
原发性肝癌（HCC）的发病率在全球范围内呈上升趋势，目前已成为全球第五大常见癌症和癌症相关死亡的第三大原因。通过监测计划早期发现 HCC，使得能够更频繁地识别出小结节，目前在西方约占 10%-15%的患者，在日本则几乎占 30%。对于小 HCC 患者，可以根据是否存在门脉高压和合并症选择潜在的治愈性治疗方法：肝移植、手术切除和经皮消融。本综述将分析这些患者临床管理的最新进展，重点关注与门脉高压的作用、切除与消融治疗之间的争论以及分子技术的未来影响有关的问题。
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