Shiani Ashok, Narayanan Shreya, Pena Luis, Friedman Mark
1 Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
2 Department of Gastroenterology, Gastrointestinal Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Cancer Control. 2017 Jul-Sep;24(3):1073274817729240. doi: 10.1177/1073274817729240.
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. Underlying chronic liver disease has been associated with an increased risk of developing HCC. This study is a review of the current literature regarding the diagnosis, prognostic significance, and role of treating underlying liver disease in patients who are at risk of primary liver cancer. Relevant peer review of the English literature between 1980 and 2017 within PubMed and the Cochrane library was conducted for scientific content on current advances in managing chronic liver diseases and the development of hepatocellular carcinoma. Hepatitis C virus, hepatitis B virus (HBV), nonalcoholic steatohepatitis, autoimmune hepatitis, hereditary hemochromatosis, Wilson disease, primary biliary cirrhosis, α 1-antitrypsin deficiency, and certain drugs lead to an increased risk of developing HCC. Patients with underlying liver disease have an increased incidence of HCC. Hepatitis C virus, HBV, and hemochromatosis can directly lead to HCC without the presence of cirrhosis, while HCC related to other underlying liver diseases occurs in patients with cirrhosis. Treating the underlying liver disease and reducing the progression to cirrhosis should lead to a decreased incidence of HCC.
肝细胞癌（HCC）是全球癌症相关死亡的第三大主要原因。潜在的慢性肝病与发生HCC的风险增加有关。本研究是对当前文献的综述，内容涉及原发性肝癌高危患者潜在肝病的诊断、预后意义及治疗作用。对1980年至2017年间PubMed和Cochrane图书馆中关于慢性肝病管理的当前进展及肝细胞癌发生的英文文献进行了相关同行评审，以获取科学内容。丙型肝炎病毒、乙型肝炎病毒（HBV）、非酒精性脂肪性肝炎、自身免疫性肝炎、遗传性血色素沉着症、威尔逊病、原发性胆汁性肝硬化、α1-抗胰蛋白酶缺乏症以及某些药物会导致发生HCC的风险增加。患有潜在肝病的患者HCC发病率增加。丙型肝炎病毒、HBV和血色素沉着症可在无肝硬化的情况下直接导致HCC，而与其他潜在肝病相关的HCC发生于肝硬化患者。治疗潜在肝病并减少向肝硬化的进展应可降低HCC的发病率。
