Longerich Thomas
Pathologisches Institut, Uniklinikum Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Deutschland.
Pathologe. 2020 Sep;41(5):478-487. doi: 10.1007/s00292-020-00801-z.
Hepatocellular carcinoma (HCC) belongs to the most prevalent and deadliest cancers worldwide. It can be attributed to well-defined risk factors (mainly chronic viral hepatitis and alcoholic/nonalcoholic steatohepatitis) leading to liver cirrhosis, a premalignant condition for the development of preneoplastic hepatocellular lesions and finally liver cancer. By applying strict morphological criteria and a panel of immunohistological markers, early HCC can be differentiated from its precursor lesions and other highly differentiated hepatocellular lesions even in most biopsy specimens. Integrative characterization led to the association of histological features and molecular subgroups of human HCC. This potentially relevant clinical development was recognized by the recently updated WHO classification of liver cancer resulting in the introduction of several HCC subtypes. These are characterized by a distinct combination of histological and molecular features, biological behavior, and clinical characteristics, allowing for a distinction from other HCC without specified features. Whether this development sets the corner stone for precision oncology of human HCC patients must be monitored.
肝细胞癌（HCC）是全球最常见、最致命的癌症之一。它可归因于明确的风险因素（主要是慢性病毒性肝炎和酒精性/非酒精性脂肪性肝炎），这些因素会导致肝硬化，而肝硬化是癌前肝细胞病变发展以及最终发展为肝癌的癌前状态。通过应用严格的形态学标准和一组免疫组织化学标志物，即使在大多数活检标本中，早期HCC也可与其前驱病变及其他高分化肝细胞病变相鉴别。综合特征分析揭示了人类HCC的组织学特征与分子亚群之间的关联。这一具有潜在相关性的临床进展已被世界卫生组织（WHO）最近更新的肝癌分类所认可，从而引入了几种HCC亚型。这些亚型具有独特的组织学和分子特征、生物学行为及临床特征组合，从而能够与其他无特定特征的HCC区分开来。这种进展是否为人类HCC患者的精准肿瘤学奠定了基石，还有待观察。
