Hospital Christus Muguerza Alta Especialidad, Monterrey, Nuevo León, Mexico.
Centro Médico Issemym, Metepec, Estado de México, Mexico.
Rev Gastroenterol Mex (Engl Ed). 2022 Apr-Jun;87(2):216-234. doi: 10.1016/j.rgmxen.2021.10.009. Epub 2022 Apr 14.
Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this first part of the document, the topics related to epidemiology and diagnosis are presented.
肝细胞癌(HCC)是更常见的表现为肝脏肝硬化的主要并发症之一,其主要危险因素。在过去十年中,其发病率有所变化,与肝硬化病因的流行病学转变有关,丙型肝炎的流行率下降,非酒精性脂肪性肝病(NAFLD)的发生率增加,以及由于 NAFLD 在非肝硬化肝脏中发生 HCC。已经确定了与该疾病相关的遗传标志物,并且监测和诊断得到了改善。关于治疗,手术技术,包括切除和移植,已经得到了发展,并且在疾病的治疗阶段,放射技术提高了患者的生存率。最后,在系统性治疗方面发生了重大变化,与十年前相比,患者的预后更加乐观。因此,墨西哥肝病协会决定开展第二次墨西哥肝细胞癌共识,这是对国内和国际上关于疾病的流行病学、危险因素、监测、诊断和治疗的现有证据的更新回顾,为墨西哥医生提供有关肝细胞癌的不同主题的最新信息。在本文件的第一部分,介绍了与流行病学和诊断相关的主题。