Starnawski Piotr, Nowak Klaudia, Augustyn Zuzanna, Malicki Dominik, Piąta Aleksandra, Lorek Dominika, Janczura Jakub
Collegium Medicum, Jan Kochanowski University, Aleja IX Wieków Kielc 19A, 25-317, Kielce, Poland.
Med Oncol. 2025 Mar 17;42(4):111. doi: 10.1007/s12032-025-02674-9.
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with chronic infections by hepatotropic viruses such as hepatitis B virus (HBV), and hepatitis C virus (HCV), being major risk factors. Chronic infections with these viruses are the leading cause of HCC worldwide, with HBV alone responsible for over 50% of cases. Despite advances in direct-acting antivirals (DAAs) for HCV and nucleos(t)ide analogues (NAs) for HBV, challenges remain in HCC prevention, early detection, and treatment. Recent research highlights the role of viral-induced metabolic alterations, such as the Warburg effect, mitochondrial dysfunction, and lipid dysregulation, in promoting HCC. Moreover, immune checkpoint inhibitors have emerged as effective treatments for advanced HCC, though responses vary between HBV- and HCV-related cancers. Additionally, novel therapeutic approaches and metabolic-targeted therapies offer promising avenues for virus-associated HCC treatment. Advancements in liquid biopsy biomarkers and artificial intelligence-driven diagnostics are improving HCC surveillance and risk stratification, potentially enabling earlier interventions. While HBV vaccination has significantly reduced HCC incidence, disparities in global vaccination coverage persist. Furthermore, antiviral therapies combined with structured surveillance programs have proven effective in reducing HCC incidence and mortality. This review highlights the complex connection between viral, genetic, and environmental factors in HCC development and underscores the importance of integrated prevention strategies to reduce its burden globally.
肝细胞癌（HCC）是全球癌症相关死亡的主要原因之一，乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）等嗜肝病毒的慢性感染是主要危险因素。这些病毒的慢性感染是全球HCC的主要原因，仅HBV就导致了超过50%的病例。尽管针对HCV的直接作用抗病毒药物（DAA）和针对HBV的核苷（酸）类似物（NA）取得了进展，但在HCC的预防、早期检测和治疗方面仍存在挑战。最近的研究强调了病毒诱导的代谢改变，如瓦伯格效应、线粒体功能障碍和脂质失调，在促进HCC中的作用。此外，免疫检查点抑制剂已成为晚期HCC的有效治疗方法，尽管HBV相关和HCV相关癌症的反应有所不同。此外，新型治疗方法和代谢靶向疗法为病毒相关HCC的治疗提供了有前景的途径。液体活检生物标志物和人工智能驱动诊断的进展正在改善HCC监测和风险分层，有可能实现更早的干预。虽然HBV疫苗接种显著降低了HCC发病率，但全球疫苗接种覆盖率仍存在差异。此外，抗病毒疗法与结构化监测计划相结合已被证明可有效降低HCC发病率和死亡率。本综述强调了HCC发生过程中病毒、遗传和环境因素之间的复杂联系，并强调了综合预防策略在全球减轻其负担方面的重要性。
