Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Oncology and Image-Guided Therapy, NAMSA, New York, NY 10021, USA.
Curr Oncol. 2023 Jul 10;30(7):6609-6622. doi: 10.3390/curroncol30070485.
Hepatocellular cancer (HCC) is the most common primary liver cancer and the third leading cause of cancer-related death. Locoregional therapies, including transarterial embolization (TAE: bland embolization), chemoembolization (TACE), and radioembolization, have demonstrated survival benefits when treating patients with unresectable HCC. TAE and TACE occlude the tumor's arterial supply, causing hypoxia and nutritional deprivation and ultimately resulting in tumor necrosis. Embolization blocks the aerobic metabolic pathway. However, tumors, including HCC, use the "Warburg effect" and survive hypoxia from embolization. An adaptation to hypoxia through the Warburg effect, which was first described in 1956, is when the cancer cells switch to glycolysis even in the presence of oxygen. Hence, this is also known as aerobic glycolysis. In this article, the adaptation mechanisms of HCC, including glycolysis, are discussed, and anti-glycolytic treatments, including systemic and locoregional options that have been previously reported or have the potential to be utilized in the treatment of HCC, are reviewed.
肝细胞癌 (HCC) 是最常见的原发性肝癌，也是癌症相关死亡的第三大主要原因。局部区域治疗，包括经动脉栓塞术 (TAE：单纯栓塞)、化疗栓塞术 (TACE) 和放射性栓塞术，在治疗不可切除的 HCC 患者时已显示出生存获益。TAE 和 TACE 阻断肿瘤的动脉供应，导致缺氧和营养剥夺，最终导致肿瘤坏死。栓塞阻断有氧代谢途径。然而，肿瘤（包括 HCC）利用“瓦博格效应”并在栓塞引起的缺氧中存活。1956 年首次描述的通过瓦博格效应适应缺氧是指即使在有氧气的情况下，癌细胞也会切换到糖酵解。因此，这也被称为有氧糖酵解。在本文中，讨论了 HCC 的适应机制，包括糖酵解，并回顾了以前报道过的或有可能用于治疗 HCC 的全身性和局部区域的抗糖酵解治疗方法。
