Department of Medicine, Imperial College London, London, UK.
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK.
Liver Int. 2019 Nov;39(11):2008-2023. doi: 10.1111/liv.14220. Epub 2019 Sep 18.
The pathogenesis of hepatocellular carcinoma (HCC) strongly relates to inflammation, with chronic up-regulation of pro-inflammatory mediators standing as a potential unifying mechanism that underscores the origin and progression of HCC independent of aetiology. Activation of the diverse pro-inflammatory mediators either within the tumour or its microenvironment is part of an active cross-talk between the progressive HCC and the host, which is known to influence clinical outcomes including recurrence after radical treatments and long-term survival. A number of clinical biomarkers to measure the severity of cancer-related inflammation are now available, most of which emerge from routine blood parameters including neutrophil, lymphocyte, platelet counts, as well as albuminaemia and C-reactive protein levels. In this review, we summarise the body of evidence supporting the biologic qualification of inflammation-based scores in HCC and review their potential in facilitating the prognostic assessment and treatment allocation in the individual patient. We also discuss the evidence to suggest modulation of tumour-promoting inflammation may act as a source of novel therapeutic strategies in liver cancer.
肝细胞癌 (HCC) 的发病机制与炎症密切相关，慢性上调促炎介质被认为是一种潜在的统一机制，强调了 HCC 的起源和进展与病因无关。肿瘤或其微环境中各种促炎介质的激活是进行性 HCC 与宿主之间积极相互作用的一部分，已知这会影响临床结果，包括根治性治疗后的复发和长期生存。目前有许多用于衡量与癌症相关炎症严重程度的临床生物标志物，其中大多数来自常规血液参数，包括中性粒细胞、淋巴细胞、血小板计数以及白蛋白和 C 反应蛋白水平。在这篇综述中，我们总结了支持基于炎症的 HCC 评分的生物学证据，并回顾了它们在个体患者的预后评估和治疗分配中的潜在应用。我们还讨论了一些证据，表明抑制肿瘤促进炎症可能成为肝癌新的治疗策略的来源。
