Xu Weiqi, Yu Jun, Wong Vincent Wai-Sun
State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
Best Pract Res Clin Gastroenterol. 2017 Jun;31(3):291-298. doi: 10.1016/j.bpg.2017.04.011. Epub 2017 May 5.
Chronic hepatitis B virus (HBV) infection remains one of the leading causes of hepatocellular carcinoma (HCC) globally. Over the past few decades, the risk factors of HCC in patients with chronic hepatitis B have been well characterized, and can be divided into host and viral factors. A few groups have also derived and validated HCC prediction scores based on these risk factors. In general, the scores have high negative predictive value in identifying a low risk group who may not need HCC surveillance in the next 3-5 years. The scores have been tested originally in Asian patients, and results on their performance in the Caucasian population are conflicting. Furthermore, new research has identified genetic factors and new virological markers (e.g. hepatitis B surface antigen and core-related antigen levels) for HCC, but they are yet to be applied in routine clinical practice.
慢性乙型肝炎病毒（HBV）感染仍然是全球肝细胞癌（HCC）的主要病因之一。在过去几十年中，慢性乙型肝炎患者发生HCC的危险因素已得到充分描述，可分为宿主因素和病毒因素。一些研究小组也基于这些危险因素得出并验证了HCC预测评分。总体而言，这些评分在识别未来3至5年可能不需要进行HCC监测的低风险人群方面具有较高的阴性预测价值。这些评分最初在亚洲患者中进行了测试，其在白种人群中的表现结果存在矛盾。此外，新的研究已经确定了HCC的遗传因素和新的病毒学标志物（如乙肝表面抗原和核心相关抗原水平），但它们尚未应用于常规临床实践。
