Li Liang, Wang Hongyang
International Co-operation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Shanghai, China.
International Co-operation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai 200438, China; National Center for Liver Cancer, Shanghai, China; National Laboratory for Oncogenes and Related Genes, Cancer Institute, RenJi Hospital, Shanghai Jiao Tong University, Shanghai 200441, China.
Cancer Lett. 2016 Sep 1;379(2):191-7. doi: 10.1016/j.canlet.2015.07.018. Epub 2015 Jul 23.
Liver cancer is an extraordinarily heterogeneous malignant disease among the tumors that have so far been identified. Hepatocellular carcinoma (HCC) arises most frequently in the setting of chronic liver inflammation and fibrosis, and takes a variety of course in individual patients to process to tumor. The risk factors such as HBV and/or HCV infections, aflatoxin infection, abuse alcohol intake, metabolic syndrome, obesity and diabetes are closely related to the environmental and genetic susceptibilities to HCC. The consequent resulting genomic instability, molecular and signal transduction network disorders and microenvironmental discrepancies are characterized by the extraordinary heterogeneity of liver cancer. The histology-based definition of the morphological heterogeneity of liver cancer has been modified and refined to treat patients with targeted therapies, but this still cannot solve all the problems. Lack of consistent outcome for anticancer agents and conventional therapies in liver cancer treatment calls for assessing the benefits of new molecularly targeted drugs and combined therapy, under the heterogeneity condition of tumor. The present review article will provide the complex mechanism and phenotype of liver cancer heterogeneity, and help us to execute precision medicine in a really personalized manner.
在目前已确定的肿瘤中，肝癌是一种异质性极高的恶性疾病。肝细胞癌（HCC）最常发生于慢性肝脏炎症和纤维化的背景下，在个体患者中发展为肿瘤的过程具有多种路径。诸如乙肝病毒和/或丙肝病毒感染、黄曲霉毒素感染、酗酒、代谢综合征、肥胖和糖尿病等风险因素与肝癌的环境易感性和遗传易感性密切相关。由此导致的基因组不稳定、分子和信号转导网络紊乱以及微环境差异是肝癌异质性极高的特征。基于组织学对肝癌形态异质性的定义已得到修改和完善，以用于靶向治疗的患者，但这仍无法解决所有问题。在肝癌治疗中，抗癌药物和传统疗法缺乏一致的疗效，这就需要在肿瘤异质性的情况下评估新型分子靶向药物和联合治疗的益处。本综述文章将阐述肝癌异质性的复杂机制和表型，并帮助我们真正以个性化的方式实施精准医学。
