肝细胞腺瘤的临床分子分类。
Molecular classification of hepatocellular adenoma in clinical practice.
机构信息
Unité Mixte de Recherche 1162, Génomique fonctionnelle des tumeurs solides, Institut National de la Santé et de la Recherche Médicale, Paris, France; Liver Unit, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France.
Pathology Department, Beaujon Hospital, APHP, Clichy 92110, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France; INSERM UMR 1149, Inflammation Research Center, Paris-Diderot University, Paris.
出版信息
J Hepatol. 2017 Nov;67(5):1074-1083. doi: 10.1016/j.jhep.2017.07.009. Epub 2017 Jul 19.
Hepatocellular adenomas (HCA) are rare benign liver tumors occurring in young women taking contraception. They are associated with rare complications such as bleeding or malignant transformation into hepatocellular carcinoma. A molecular classification has divided HCA in several subgroups linked with risk factors, clinical behaviour, histological features and imaging: HNF1A inactivated HCA, Inflammatory HCA, CTNNB1 mutated HCA in exon 3, CTNNB1 mutated in exon 7 and 8 HCA, sonic hedgehog HCA and unclassified HCA. CTNNB1 mutated HCA in exon 3 and sonic hedgehog HCA have been linked with a high risk of malignant transformation and bleeding respectively. Herein, we review how molecular classification has modified our understanding of the pathophysiology and risk factors of HCA development, analysing its impact on clinical care in the field of diagnosis and therapeutic stratification.
肝细胞腺瘤（HCA）是一种罕见的良性肝肿瘤，发生在服用避孕药的年轻女性中。它们与一些罕见的并发症相关，如出血或恶性转化为肝细胞癌。分子分类将 HCA 分为几个亚组，与危险因素、临床行为、组织学特征和影像学相关：HNF1A 失活的 HCA、炎症性 HCA、CTNNB1 突变的 HCA 在第 3 外显子、CTNNB1 突变的 HCA 在第 7 和 8 外显子、sonic hedgehog HCA 和未分类的 HCA。CTNNB1 突变的 HCA 在第 3 外显子和 sonic hedgehog HCA 分别与恶性转化和出血的高风险相关。在此，我们回顾了分子分类如何改变了我们对 HCA 发展的病理生理学和危险因素的理解，分析了其对诊断和治疗分层领域临床护理的影响。
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