Lu Jialin, Liu Xiaoyu, Fan Kaiyan, Lin Xiaofeng
Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, People's Republic of China.
Cancer Manag Res. 2025 Apr 8;17:779-792. doi: 10.2147/CMAR.S513729. eCollection 2025.
Liver cancer is a significant global health concern, with projections indicating that the incidence of morbidity may surpass one million cases by 2025. Hepatocellular carcinoma (HCC) is the predominant subtype of liver cancer, constituting approximately 90% of all liver cancer diagnoses. Infections caused by the hepatitis B virus (HBV) and hepatitis C virus (HCV) are recognized as primary risk factors for the development of HCC. However, non-alcoholic steatohepatitis (NASH), which is often linked to metabolic syndrome or diabetes, is increasingly being recognized as a prevalent risk factor in Western populations. Furthermore, HCC associated with NASH exhibits distinct molecular pathogenesis. Patients diagnosed with HCC have access to a range of therapeutic interventions, including liver transplantation, surgical resection, percutaneous ablation, radiation therapy, and transarterial and systemic therapies. Consequently, effective clinical decision-making requires a multidisciplinary approach to adapt individualized treatment plans based on the patient's tumor stage, liver function, and overall performance status. The approval of new first- and second-line pharmacological agents, along with the establishment of immune checkpoint inhibitor therapies as standard treatment modalities, has contributed to an improved prognosis for patients with HCC. Nevertheless, the optimal sequencing of these therapeutic agents remains to be elucidated, highlighting the urgent need for predictive biomarkers to inform treatment selections. Traditional Chinese Medicine (TCM) has demonstrated potential as a complementary and alternative therapeutic approach for liver cancer, warranting further investigation. This review aimed to examine the comprehensive treatment of HCC through the lens of TCM, informed by the current understanding of its epidemiology, diagnosis, and pathophysiology.
肝癌是一个重大的全球健康问题，据预测，到2025年，其发病病例数可能超过100万例。肝细胞癌（HCC）是肝癌的主要亚型，约占所有肝癌诊断病例的90%。乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）引起的感染被认为是HCC发生的主要危险因素。然而，通常与代谢综合征或糖尿病相关的非酒精性脂肪性肝炎（NASH）在西方人群中越来越被认为是一种普遍的危险因素。此外，与NASH相关的HCC表现出独特的分子发病机制。被诊断为HCC的患者可以获得一系列治疗干预措施，包括肝移植、手术切除、经皮消融、放射治疗以及经动脉和全身治疗。因此，有效的临床决策需要多学科方法，根据患者的肿瘤分期、肝功能和整体功能状态来调整个体化治疗方案。新的一线和二线药物的批准，以及免疫检查点抑制剂疗法作为标准治疗方式的确立，有助于改善HCC患者的预后。然而，这些治疗药物的最佳使用顺序仍有待阐明，这凸显了迫切需要预测性生物标志物来指导治疗选择。传统中医（TCM）已显示出作为肝癌辅助和替代治疗方法的潜力，值得进一步研究。本综述旨在结合当前对HCC流行病学、诊断和病理生理学的认识，从中医角度探讨HCC的综合治疗。
