Miamen Alexander G, Dong Haidong, Roberts Lewis R
Division of Gastroenterology and Hepatology, College of Medicine College of Medicine, Mayo Clinic, Minnesota, USA ; Department of Immunology, Mayo Graduate and Medical Schools College of Medicine, Mayo Clinic, Minnesota, USA.
Liver Cancer. 2012 Nov;1(3-4):226-37. doi: 10.1159/000343837.
Liver cancer, the most common form of which is hepatocellular carcinoma (HCC), is one of the most deadly cancers worldwide. As of 2008, in men, HCC was the fifth most common cancer (approximately 450,000 new cases per year) and the second most frequent cause of death from cancer (around 416,000 deaths per year), whereas in women, it was the seventh most frequently diagnosed cancer (150,000 new cases per year) and the sixth most frequent cause of cancer deaths (140,000 deaths per year) [1]. Overall, HCC is the third leading cause of death from cancer globally [2, 3]. Worldwide, the incidence of HCC in males is more than twice that in females. The etiology of HCC is diverse; however, approximately 80% of HCCs occur secondary to chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) [4]. The geographic distribution of HCC is such that the high-incidence regions of Eastern Asia and sub-Saharan Africa bear a disproportionate HCC burden, amounting to more than 80% of the global burden [4]. However, even in areas considered low-incidence regions-North America and Europe-the incidence of HCC is on the rise [4]. In the US, HCC incidence has risen more than threefold in the past 30 years, and it is now the ninth most frequent cause of death from cancer. The major reasons for the increased incidence of HCC in the US are the increasing prevalence of chronic HCV infection, increased immigration from high-incidence countries in Asia and Africa, and the increase in the number of individuals with cirrhosis due to obesity-related fatty liver disease. Most HCCs are diagnosed at an advanced stage for which there is no curative option. Sorafenib, the only agent specifically approved for HCC treatment, is of limited efficacy in this setting. Therefore, an urgent need for improved HCC therapy exists. In this review, we discuss the available data on the development and use of immunotherapy for HCC, with a particular focus on recent results and novel approaches.
肝癌，其最常见的类型是肝细胞癌（HCC），是全球最致命的癌症之一。截至2008年，在男性中，HCC是第五大常见癌症（每年约45万新发病例），也是癌症死亡的第二大常见原因（每年约41.6万例死亡），而在女性中，它是第七大最常被诊断出的癌症（每年15万新发病例），也是癌症死亡的第六大常见原因（每年14万例死亡）[1]。总体而言，HCC是全球癌症死亡的第三大主要原因[2,3]。在全球范围内，男性HCC的发病率是女性的两倍多。HCC的病因多种多样；然而，大约80%的HCC继发于乙型肝炎病毒（HBV）和/或丙型肝炎病毒（HCV）的慢性感染[4]。HCC的地理分布情况是，东亚和撒哈拉以南非洲的高发病率地区承担了不成比例的HCC负担，占全球负担的80%以上[4]。然而，即使在被认为是低发病率地区的北美和欧洲，HCC的发病率也在上升[4]。在美国，HCC发病率在过去30年中上升了三倍多，现在是癌症死亡的第九大常见原因。美国HCC发病率上升的主要原因是慢性HCV感染的患病率增加、来自亚洲和非洲高发病率国家的移民增加，以及肥胖相关脂肪性肝病导致的肝硬化患者数量增加。大多数HCC在晚期被诊断出来，而晚期HCC没有治愈的选择。索拉非尼是唯一专门批准用于HCC治疗的药物，在这种情况下疗效有限。因此，迫切需要改进HCC治疗方法。在本综述中，我们讨论了关于HCC免疫治疗发展和应用的现有数据，特别关注近期结果和新方法。
