Ong Yuki, Huey Cheong Wei Terence, Shelat Vishalkumar Girishchandra
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Hepato-Pancreatico-Biliary Surgery, Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Expert Rev Gastroenterol Hepatol. 2022 May;16(5):449-471. doi: 10.1080/17474124.2022.2085556. Epub 2022 Jun 8.
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and a significant proportion (20-40%) of patients with HCC develop paraneoplastic syndromes (PNS). Despite this, there is a paucity of clinical evidence regarding PNS in HCC.
A systematic search was performed to identify relevant case studies regarding PNS in HCC. Another search was conducted to identify studies that evaluated the impact of PNS on survival outcomes in HCC. Since there are currently no international guidelines for PNS in HCC, this review aims to provide comprehensive summaries and recommendations of PNS in HCC, including the pathophysiology, clinical features, diagnostic approach, and management, so that clinicians remain guided in caring for HCC patients with PNS. In general, PNS are associated with poorer survival outcomes and negative prognostic markers of HCC.
The presence of PNS has a significant influence on survival rates and clinical outcomes of patients with HCC. They contribute to significant morbidity, influencing patients' quality of life and fitness for curative and palliative therapies. Therefore, it is paramount for PNS to be integrated into routine investigations after diagnosing HCC to guide further management and prognostication of the disease.
肝细胞癌（HCC）是全球最常见的癌症之一，相当一部分（20%-40%）HCC患者会发生副肿瘤综合征（PNS）。尽管如此，关于HCC中PNS的临床证据却很匮乏。
进行了系统检索以确定有关HCC中PNS的相关病例研究。还进行了另一项检索以确定评估PNS对HCC生存结局影响的研究。由于目前尚无关于HCC中PNS的国际指南，本综述旨在全面总结和推荐HCC中的PNS，包括其病理生理学、临床特征、诊断方法和管理，以便临床医生在护理患有PNS的HCC患者时仍能得到指导。一般而言，PNS与HCC较差的生存结局和不良预后标志物相关。
PNS的存在对HCC患者的生存率和临床结局有重大影响。它们会导致严重的发病率，影响患者的生活质量以及接受根治性和姑息性治疗的适用性。因此，在诊断HCC后将PNS纳入常规检查以指导疾病的进一步管理和预后至关重要。
