Department of Transplantation/Pediatric Surgery, Postgraduate School of Life Science, Kumamoto University, Kumamoto, Japan.
Biosci Trends. 2022 Jul 20;16(3):207-211. doi: 10.5582/bst.2022.01199. Epub 2022 May 26.
Liver transplantation is one of the best treatment options for selected patients with hepatocellular carcinoma (HCC). The Milan criteria (a single tumor with a maximum size of 5 cm or two or three tumors with a maximum size of 3 cm without evidence of vascular or extrahepatic involvement or metastasis) are one of the most common criteria to select patients with HCC for transplantation, though they are considered too restrictive. A moderate expansion of the criteria has been found to yield comparable recurrence-free survival rates. HCC will recur in approximately 10% of patients, and mostly within the first 2 years after transplantation. The preoperative level of alpha-fetoprotein, macrovascular invasion, tumor size, and tumor number are prognostic factors for recurrence. Recurrence of HCC after transplantation results in a poor prognosis.
肝移植是治疗特定肝细胞癌 (HCC) 患者的最佳选择之一。米兰标准（单个肿瘤最大直径 5cm，或 2-3 个肿瘤最大直径均 3cm，无血管或肝外侵犯或转移的证据）是选择 HCC 患者进行移植的最常用标准之一，但被认为过于严格。适度扩大标准已被发现可获得可比的无复发生存率。约 10%的患者 HCC 会复发，且大多在移植后 2 年内。术前甲胎蛋白水平、大血管侵犯、肿瘤大小和肿瘤数量是复发的预后因素。移植后 HCC 复发导致预后不良。
