Brito Ana Filipa, Abrantes Ana Margarida, Tralhão José Guilherme, Botelho Maria Filomena
Oncol Rev. 2016 Oct 10;10(2):302. doi: 10.4081/oncol.2016.302.
Hepatocellular carcinoma (HCC) is increasingly considered an issue of global importance. Its rates of incidence and mortality have been markedly increasing over the last decades. Among risk factors, some should be highlighted, namely the infections by hepatitis B and C virus, as well as clinical cases of cirrhosis. HCC is characterized as asymptomatic disease in the initial stages which most often leads to a late diagnosis. At molecular and genetic level HCC represents a highly complex tumor entity, including a wide variety of mutations, thus accounting for different mechanisms of resistance towards therapeutic approaches. In particular, mutations of the gene, as well as a deregulation between the expression of pro- and anti-apoptotic proteins of the BCL-2 family are observed. Regarding treatment modalities, surgical procedures offer the best chance of cure, however, due to a late diagnosis, most of concerned patients cannot be subjected to them. Chemotherapy and radiotherapy are also ineffective, and currently, the treatment with sorafenib is the most commonly used systemic therapy although it can only increase the patient survival for some months. In this sense, a quick and accurate investigation is of utmost importance in order to develop ways of early diagnosis as well as new therapies for HCC.
肝细胞癌(HCC)日益被视为一个具有全球重要性的问题。在过去几十年中,其发病率和死亡率一直在显著上升。在风险因素中,一些因素应予以突出强调,即乙型和丙型肝炎病毒感染以及肝硬化临床病例。HCC在初始阶段表现为无症状疾病,这常常导致诊断延迟。在分子和基因水平上,HCC是一个高度复杂的肿瘤实体,包括各种各样的突变,从而导致对治疗方法产生不同的耐药机制。特别是,观察到该基因的突变以及BCL - 2家族促凋亡蛋白和抗凋亡蛋白表达之间的失调。关于治疗方式,外科手术提供了最佳的治愈机会,然而,由于诊断延迟,大多数相关患者无法接受手术治疗。化疗和放疗也无效,目前,索拉非尼治疗是最常用的全身治疗方法,尽管它只能使患者存活延长几个月。从这个意义上说,为了开发HCC的早期诊断方法和新疗法,快速而准确的研究至关重要。