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乙型肝炎病毒相关肝细胞癌肝切除术后结局的围手术期预测因素

Perioperative predictors of outcome of hepatectomy for HBV-related hepatocellular carcinoma.

作者信息

He Ziming, Tang Di

机构信息

Department of General Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.

出版信息

Front Oncol. 2023 Jul 13;13:1230164. doi: 10.3389/fonc.2023.1230164. eCollection 2023.

Abstract

Hepatitis B virus (HBV) is identified as a major risk factor for hepatocellular carcinoma (HCC), resulting in so-called hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC). Hepatectomy for HCC is acknowledged as an efficient treatment strategy, especially for early HCC. Furthermore, patients with advanced HCC can still obtain survival benefits through surgical treatment combined with neoadjuvant therapy, adjuvant therapy, transcatheter arterial chemoembolization, and radiofrequency ablation. Therefore, preoperative and postoperative predictors of HBV-related HCC have crucial indicative functions for the follow-up treatment of patients with feasible hepatectomy. This review covers a variety of research results on preoperative and postoperative predictors of hepatectomy for HBV-related HCC over the past decade and in previous landmark studies. The relevant contents of Hepatitis C virus-related HCC, non-HBV non-HCV HCC, and the artificial intelligence application in this field are briefly addressed in the extended content. Through the integration of this review, a large number of preoperative and postoperative factors can predict the prognosis of HBV-related HCC, while most of the predictors have no standardized thresholds. According to the characteristics, detection methods, and application of predictors, the predictors can be divided into the following categories: 1. serological and hematological predictors, 2. genetic, pathological predictors, 3. imaging predictors, 4. other predictors, 5. analysis models and indexes. Similar results appear in HCV-related HCC, non-HBV non-HCV HCC. Predictions based on AI and big biological data are actively being applied. A reasonable prediction model should be established based on the economic, health, and other levels in specific countries and regions.

摘要

乙型肝炎病毒(HBV)被认为是肝细胞癌(HCC)的主要危险因素,可导致所谓的乙型肝炎病毒相关肝细胞癌(HBV相关HCC)。肝癌肝切除术被公认为一种有效的治疗策略,尤其是对于早期肝癌。此外,晚期肝癌患者通过手术治疗联合新辅助治疗、辅助治疗、经动脉化疗栓塞和射频消融仍可获得生存益处。因此,HBV相关HCC的术前和术后预测指标对于可行肝切除术患者的后续治疗具有关键的指示作用。本综述涵盖了过去十年以及以往标志性研究中关于HBV相关HCC肝切除术术前和术后预测指标的各种研究结果。扩展内容中简要介绍了丙型肝炎病毒相关HCC、非HBV非HCV HCC以及该领域人工智能应用的相关内容。通过本综述的整合,大量术前和术后因素可预测HBV相关HCC的预后,但大多数预测指标尚无标准化阈值。根据预测指标的特点、检测方法和应用情况,可将其分为以下几类:1. 血清学和血液学预测指标;2. 遗传、病理学预测指标;3. 影像学预测指标;4. 其他预测指标;5. 分析模型和指标。丙型肝炎病毒相关HCC、非HBV非HCV HCC中也出现了类似结果。基于人工智能和大生物数据的预测正在积极应用。应根据特定国家和地区的经济、健康等层面建立合理的预测模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe6b/10373594/91e9e9200bb9/fonc-13-1230164-g001.jpg

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