Lang V Bralić
Acta Med Croatica. 2015 Nov;69(4):327-32.
Hepatocellular carcinoma (HCC) is the most common malignancy of the liver, the sixth most common cause of cancer and the third leading cause of cancer-related deaths worldwide. Its incidence has increased dramatically throughout the world mainly driven by the increasing numbers of persons with long-standing chronic hepatitis C virus (HCV) infection who develop cirrhosis. Although 90% of HCV-associated HCC cases occur concurrently with cirrhosis, 30% to 50% of liver cancers associated with chronic HBV occur in the absence of cirrhosis. Since most people with chronic hepatitis are asymptomatic until cirrhosis or HCC is established, initial diagnosis and management of chronic hepatitis rely on primary care physicians to identify and screen high-risk individuals. Studies show that family physicians have inadequate knowledge about screening and counseling for chronic hepatitis and HCC. There is evidence of advances in surgical and nonsurgical therapies in the treatment of HCC, thus different associations have updated their recommendations following these clinical and scientific advances. The aim of this review is to make family physicians familiar with novelties in identifying high-risk patients, implementing an appropriate screening strategy, diagnosis and treatment, and to assist them in the decision-making process according to evidence based data.
肝细胞癌（HCC）是最常见的肝脏恶性肿瘤，是全球第六大常见癌症病因以及癌症相关死亡的第三大主要原因。其发病率在全球范围内急剧上升，主要是由于长期慢性丙型肝炎病毒（HCV）感染导致肝硬化的人数增加所致。虽然90%的与HCV相关的HCC病例与肝硬化同时发生，但30%至50%的与慢性HBV相关的肝癌发生在无肝硬化的情况下。由于大多数慢性肝炎患者在肝硬化或HCC形成之前没有症状，慢性肝炎的初始诊断和管理依赖于初级保健医生来识别和筛查高危个体。研究表明，家庭医生对慢性肝炎和HCC的筛查及咨询知识不足。有证据表明，HCC治疗中的手术和非手术疗法取得了进展，因此不同协会根据这些临床和科学进展更新了他们的建议。本综述的目的是让家庭医生熟悉识别高危患者、实施适当筛查策略、诊断和治疗方面的新情况，并根据循证数据协助他们进行决策。
