病毒性肝炎诱导肝细胞癌的分子机制。
Molecular mechanisms of viral hepatitis induced hepatocellular carcinoma.
机构信息
Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, AB, Canada.
出版信息
World J Gastroenterol. 2020 Oct 14;26(38):5759-5783. doi: 10.3748/wjg.v26.i38.5759.
Chronic infection with viral hepatitis affects half a billion individuals worldwide and can lead to cirrhosis, cancer, and liver failure. Liver cancer is the third leading cause of cancer-associated mortality, of which hepatocellular carcinoma (HCC) represents 90% of all primary liver cancers. Solid tumors like HCC are complex and have heterogeneous tumor genomic profiles contributing to complexity in diagnosis and management. Chronic infection with hepatitis B virus (HBV), hepatitis delta virus (HDV), and hepatitis C virus (HCV) are the greatest etiological risk factors for HCC. Due to the significant role of chronic viral infection in HCC development, it is important to investigate direct (viral associated) and indirect (immune-associated) mechanisms involved in the pathogenesis of HCC. Common mechanisms used by HBV, HCV, and HDV that drive hepatocarcinogenesis include persistent liver inflammation with an impaired antiviral immune response, immune and viral protein-mediated oxidative stress, and deregulation of cellular signaling pathways by viral proteins. DNA integration to promote genome instability is a feature of HBV infection, and metabolic reprogramming leading to steatosis is driven by HCV infection. The current review aims to provide a brief overview of HBV, HCV and HDV molecular biology, and highlight specific viral-associated oncogenic mechanisms and common molecular pathways deregulated in HCC, and current as well as emerging treatments for HCC.
慢性病毒性肝炎感染影响全球半数人口,并可导致肝硬化、癌症和肝衰竭。肝癌是癌症相关死亡的第三大主要原因,其中肝细胞癌(HCC)占所有原发性肝癌的 90%。像 HCC 这样的实体瘤是复杂的,具有异质性的肿瘤基因组特征,这导致了诊断和管理的复杂性。乙型肝炎病毒(HBV)、丁型肝炎病毒(HDV)和丙型肝炎病毒(HCV)的慢性感染是 HCC 的最大病因风险因素。由于慢性病毒感染在 HCC 发展中的重要作用,因此研究 HCC 发病机制中涉及的直接(病毒相关)和间接(免疫相关)机制非常重要。HBV、HCV 和 HDV 驱动肝癌发生的常见机制包括持续的肝脏炎症伴抗病毒免疫反应受损、免疫和病毒蛋白介导的氧化应激以及病毒蛋白对细胞信号通路的失调。促进基因组不稳定性的 DNA 整合是 HBV 感染的特征,而由 HCV 感染引起的代谢重编程导致脂肪变性。本综述旨在简要概述 HBV、HCV 和 HDV 的分子生物学,并重点介绍 HCC 中特定的病毒相关致癌机制和常见的分子途径失调,以及 HCC 的现有和新兴治疗方法。