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肝细胞癌:预防、诊断和治疗。

Hepatocellular Carcinoma: Prevention, Diagnosis, and Treatment.

机构信息

Ultrasound Medicine, The First Hospital of Lanzhou University, Lanzhou, China,

Department of Gastroenterology, The First Hospital of Lanzhou University, Key Laboratory for Gastrointestinal Disease of Gansu Province, Lanzhou, China.

出版信息

Med Princ Pract. 2024;33(5):414-423. doi: 10.1159/000539349. Epub 2024 May 21.

Abstract

Hepatocellular carcinoma (HCC), the most prevalent form of liver cancer globally, poses a substantial health burden. Influenced by risk factors such as hepatitis B or C virus infections, chronic consumption of alcohol, and metabolic dysfunction, its exact etiology likely involves a complex interplay between viral infection, hepatocyte mutations, and chronic liver diseases like cirrhosis and metabolic dysfunction-associated steatohepatitis, and demographic variables like sex, race, and age. Disease stage significantly impacts the prognosis of HCC. There is significant potential for life-saving and socioeconomic benefits through the implementation of surveillance programs and the introduction of low-cost screening measures for high-risk groups; these screening measures include ultrasound imaging and blood tests. Treatment options for HCC encompass liver resection, transplantation, transarterial chemoembolization, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. Despite therapeutic advances, treating advanced HCC remains challenging, emphasizing the need for continued efforts in prevention, early detection, and development of treatments to improve prognosis and long-term survival.

摘要

肝细胞癌(HCC)是全球最常见的肝癌形式,给健康带来了重大负担。其确切病因可能受到乙型或丙型肝炎病毒感染、慢性饮酒、代谢功能障碍等危险因素的影响,涉及病毒感染、肝细胞突变以及肝硬化和代谢功能障碍相关性脂肪性肝炎等慢性肝病之间的复杂相互作用,以及性别、种族和年龄等人口统计学变量。疾病分期显著影响 HCC 的预后。通过实施监测计划和为高危人群引入低成本筛查措施,如超声成像和血液检查,具有显著的挽救生命和社会效益潜力。HCC 的治疗选择包括肝切除术、肝移植、经动脉化疗栓塞、放射治疗、化疗、靶向治疗和免疫治疗。尽管治疗有所进展,但治疗晚期 HCC 仍然具有挑战性,这强调了需要继续努力预防、早期发现和开发治疗方法,以改善预后和长期生存。

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