Guan Ming-Cheng, Wang Ming-Da, Liu Si-Yu, Ouyang Wei, Liang Lei, Pawlik Timothy M, Xu Qiu-Ran, Huang Dong-Sheng, Shen Feng, Zhu Hong, Yang Tian
Department of Medical Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.
Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital (Navy Medical University), Second Military Medical University, Shanghai 200438, China.
World J Gastrointest Oncol. 2021 Apr 15;13(4):197-215. doi: 10.4251/wjgo.v13.i4.197.
Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths worldwide. The prognosis of patients with HCC remains poor largely due to the late diagnosis and lack of effective treatments. Despite being widely used, alpha-fetoprotein serology and ultrasonography have limited diagnostic performance for early-stage HCC. The emergence of omics strategies has contributed to significant advances in the development of non-invasive biomarkers for the early diagnosis of HCC including proteins, metabolites, circulating tumor deoxyribonucleic acid, and circulating non-coding ribonucleic acid. Early diagnosis is beneficial to patients as it increases the proportion who can be treated with curative treatment, thus prolonging survival outcomes. Currently, multiple clinical trials involving locoregional, systemic therapies, and combinations of these modalities are changing therapeutic strategies for different stage HCC. Success in several preclinical trials that involve immunotherapeutic innovations has created the potential to complement and enforce other treatment strategies in the future. This review summarizes the most recent advances in non-invasive early molecular detection, current therapy strategies, and potential immunotherapeutic innovations of HCC.
肝细胞癌(HCC)是全球第四大致癌相关死亡原因。HCC患者的预后仍然很差,主要是由于诊断较晚且缺乏有效的治疗方法。尽管甲胎蛋白血清学和超声检查被广泛使用,但它们对早期HCC的诊断性能有限。组学策略的出现推动了HCC早期诊断的非侵入性生物标志物(包括蛋白质、代谢物、循环肿瘤脱氧核糖核酸和循环非编码核糖核酸)开发取得重大进展。早期诊断对患者有益,因为它增加了可以接受根治性治疗的患者比例,从而延长了生存结果。目前,多项涉及局部区域治疗、全身治疗以及这些治疗方式组合的临床试验正在改变不同阶段HCC的治疗策略。一些涉及免疫治疗创新的临床前试验取得成功,为未来补充和强化其他治疗策略创造了潜力。本综述总结了HCC非侵入性早期分子检测、当前治疗策略以及潜在免疫治疗创新的最新进展。