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肝细胞癌和肝内胆管癌的流行病学

Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.

作者信息

Massarweh Nader N, El-Serag Hashem B

机构信息

1 U.S. Department of Veterans Affairs Health Services Research and Development Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.

2 Michael E. DeBakey Department of Surgery, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.

出版信息

Cancer Control. 2017 Jul-Sep;24(3):1073274817729245. doi: 10.1177/1073274817729245.

Abstract

Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the most frequently occurring types of primary liver cancer and together are among the most common incident cancers worldwide. There are a number of modifiable and nonmodifiable HCC and ICC risk factors that have been reported. A review of the existing literature the epidemiology and risk factors for HCC and ICC was performed. There are a number of major infectious, lifestyle, metabolic, and heritable risk factors for both HCC and ICC. Some of these risk factors are either potentially preventable (eg, alcohol and tobacco use) or are currently treatable (eg hepatitis infection). In most cases, the molecular pathway or mechanism by which these etiologic factors cause primary liver cancer has not been well delineated. However, in nearly all cases, it is believed that a given risk factor causes liver injury and inflammation which results in chronic liver disease. Given the rising prevalence of several common HCC and ICC risk factors in the western world, the best opportunities for improving the care of these patients are either through the prevention of modifiable risk factors that are associated with the development of chronic liver disease or the identification of at risk patients, ensuring they are appropriately screened for the development of primary liver cancer, and initiating treatment early.

摘要

肝细胞癌(HCC)和肝内胆管癌(ICC)是原发性肝癌最常见的类型,并且共同位列全球最常见的新发癌症之中。已有多项可改变和不可改变的HCC和ICC危险因素被报道。我们对现有文献进行了回顾,以了解HCC和ICC的流行病学及危险因素。HCC和ICC存在许多主要的感染、生活方式、代谢及遗传危险因素。其中一些危险因素要么具有潜在可预防性(如饮酒和吸烟),要么目前可治疗(如肝炎感染)。在大多数情况下,这些病因导致原发性肝癌的分子途径或机制尚未完全阐明。然而,几乎在所有情况下,人们认为特定的危险因素会导致肝损伤和炎症,进而引发慢性肝病。鉴于西方世界几种常见的HCC和ICC危险因素患病率不断上升,改善这些患者治疗的最佳机会要么是通过预防与慢性肝病发展相关的可改变危险因素,要么是识别高危患者,确保他们得到原发性肝癌发展方面的适当筛查,并尽早开始治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf2f/5937247/c7fc99e636cd/10.1177_1073274817729245-fig1.jpg

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