Di Bisceglie A M, Rustgi V K, Hoofnagle J H, Dusheiko G M, Lotze M T
Ann Intern Med. 1988 Mar;108(3):390-401. doi: 10.7326/0003-4819-108-3-390.
Hepatocellular carcinoma is the most frequent cancer worldwide, responsible for approximately 1,000,000 deaths annually, most of them in the Far East and in sub-Saharan Africa. It usually presents at an advanced stage and has a poor prognosis. There is evidence of an etiologic role for hepatitis B virus infection in the etiology of hepatocellular carcinoma. Carriers of the virus are 94 times more at risk for hepatocellular carcinoma than noncarriers. In many cases hepatitis B virus DNA is integrated within the cellular genome of the tumor. Programs have been established to detect hepatocellular carcinoma at an early stage; persons at high risk are regularly screened by measurement of serum alpha-fetoprotein levels and ultrasound examination of the liver. Surgical resection offers the only hope of cure at present, as chemotherapy, radiotherapy, and immunotherapy have not shown promise. Ideally, surgery should be done on small asymptomatic tumors.
肝细胞癌是全球最常见的癌症，每年导致约100万人死亡，其中大多数发生在远东和撒哈拉以南非洲地区。它通常在晚期出现，预后较差。有证据表明乙型肝炎病毒感染在肝细胞癌的病因中起病因学作用。病毒携带者患肝细胞癌的风险是非携带者的94倍。在许多情况下，乙型肝炎病毒DNA整合在肿瘤的细胞基因组中。已经建立了早期检测肝细胞癌的项目；高危人群通过检测血清甲胎蛋白水平和肝脏超声检查进行定期筛查。目前手术切除是唯一的治愈希望，因为化疗、放疗和免疫疗法都没有显示出效果。理想情况下，手术应在无症状的小肿瘤上进行。
