Gastroenterology Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
The Corporal Michael J. Crescenz VA Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Hepatology. 2021 Jan;73 Suppl 1(Suppl 1):27-37. doi: 10.1002/hep.31481. Epub 2020 Nov 7.
Chronic hepatitis B and C viral infections are major risk factors for hepatocellular carcinoma (HCC) in the United States and worldwide. Direct and indirect mechanisms of viral infection lead to the development of HCC. Chronic viral infection leads to inflammation and liver damage, culminating in cirrhosis, the penultimate step in the progression toward HCC. Host, viral, and environmental factors likely interact to promote oncogenesis. Clinical considerations include recommendations for screening for HCC in persons at risk, treatment with antivirals, and an emerging role for immunotherapy in HCC. We pose unanswered questions regarding HCC susceptibility and pathogenesis in the setting of chronic hepatitis B and C.
慢性乙型肝炎和丙型肝炎病毒感染是美国和全球肝细胞癌（HCC）的主要危险因素。病毒感染的直接和间接机制导致 HCC 的发生。慢性病毒感染导致炎症和肝损伤，最终导致肝硬化，这是 HCC 进展的倒数第二步。宿主、病毒和环境因素可能相互作用以促进癌变。临床考虑因素包括对高危人群进行 HCC 筛查的建议、抗病毒治疗以及免疫疗法在 HCC 中的新作用。我们对慢性乙型肝炎和丙型肝炎背景下的 HCC 易感性和发病机制提出了尚未解决的问题。
