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抗病毒治疗在根治性切除术后乙肝病毒相关性肝细胞癌降低复发率及提高生存率中的作用(综述)

Role of antiviral therapy in reducing recurrence and improving survival in hepatitis B virus-associated hepatocellular carcinoma following curative resection (Review).

作者信息

Zuo Chaohui, Xia Man, Wu Qunfeng, Zhu Haizhen, Liu Jingshi, Liu Chen

机构信息

Department of Gastroduodenal and Pancreatic Surgery, Translation Medicine Research Center of Liver Cancer, Hunan Province Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan 410013, P.R. China ; Department of Pathology, Immunology and Laboratory Medicine and Shands Cancer Center, University of Florida, Gainesville, FL 32610-0275, USA.

Department of Pathology, Immunology and Laboratory Medicine and Shands Cancer Center, University of Florida, Gainesville, FL 32610-0275, USA ; Department of Gynaecological Oncology, Hunan Province Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan 410013, P.R. China.

出版信息

Oncol Lett. 2015 Feb;9(2):527-534. doi: 10.3892/ol.2014.2727. Epub 2014 Nov 21.

Abstract

Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality worldwide, with the majority of cases associated with persistent hepatitis B virus (HBV) or hepatitis C virus infection. In particular, chronic HBV infection is a predominant risk factor for the development of HCC in Asian and African populations. Hepatic resection, liver transplantion and radiofrequency ablation are increasingly used for the curative treatment of HCC, however, the survival rate of HCC patients who have undergone curative resection remains unsatisfactory due to the high recurrence rate. HCC is a complex disease that is typically resistant to the most commonly used types of chemotherapy and radiotherapy; therefore, the development of novel treatment strategies is required to improve the survival rate of this disease. A high viral load of HBV DNA is the most important correctable risk factor for HCC recurrence, for example nucleos(t)ide analogs improve the outcome following curative resection of HBV-associated HCC, and interferon-α exhibits antitumor activity against various types of cancer via direct inhibitory effects on tumor cells, anti-angiogenesis, enhanced immunogenicity of tumors, immunomodulatory effects and liver dysfunction. In the present review, antiviral treatment for HBV-associated HCC is described as a strategy to reduce recurrence and improve survival.

摘要

肝细胞癌(HCC)是全球癌症相关死亡的主要原因之一,大多数病例与持续性乙型肝炎病毒(HBV)或丙型肝炎病毒感染有关。特别是,慢性HBV感染是亚洲和非洲人群发生HCC的主要危险因素。肝切除术、肝移植和射频消融越来越多地用于HCC的根治性治疗,然而,由于复发率高,接受根治性切除的HCC患者的生存率仍然不尽人意。HCC是一种复杂的疾病,通常对最常用的化疗和放疗类型具有抗性;因此,需要开发新的治疗策略来提高这种疾病的生存率。高病毒载量的HBV DNA是HCC复发最重要的可纠正危险因素,例如核苷(酸)类似物可改善HBV相关HCC根治性切除后的预后,而α干扰素通过对肿瘤细胞的直接抑制作用、抗血管生成、增强肿瘤的免疫原性、免疫调节作用和肝功能障碍,对各种类型的癌症具有抗肿瘤活性。在本综述中,HBV相关HCC的抗病毒治疗被描述为一种降低复发率和提高生存率的策略。

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