Ramsey W H, Wu G Y
Department of Medicine, University of Connecticut School of Medicine, Farmington, USA.
Dig Dis. 1995 Mar-Apr;13(2):81-91. doi: 10.1159/000171490.
In this review, the current approach to the screening, diagnostic evaluation, staging, and treatment for hepatocellular carcinoma (HCC) is outlined. The serum alpha-fetoprotein (AFP) level and abdominal ultrasonography (US) remain the cornerstones of screening protocols for HCC. Other serum marker proteins, such as abnormal serum prothrombin (PIVKA-II), when used in conjunction with AFP, can increase the yield for HCC. For diagnosis and staging of HCC, other imaging modalities employed include CT scan, infusion hepatic angiography, CT with arterial portography or iodized oil enhancement, MRI with contrast enhancement, intraoperative US, and US-guided fine-needle aspiration cytology and biopsy. Treatment options which have afforded some improvement in survival and tumor regression include surgical resection, orthotopic liver transplantation, percutaneous injection of ethanol, arterial chemoembolization, cryotherapy, and systemic or regional chemotherapy. Despite these advances, the diagnosis of HCC still portends a dismal prognosis.
在本综述中，概述了目前肝细胞癌（HCC）的筛查、诊断评估、分期及治疗方法。血清甲胎蛋白（AFP）水平和腹部超声检查（US）仍然是HCC筛查方案的基石。其他血清标志物蛋白，如异常血清凝血酶原（PIVKA-II），与AFP联合使用时，可提高HCC的检出率。对于HCC的诊断和分期，采用的其他成像方式包括CT扫描、肝灌注血管造影、动脉门静脉造影CT或碘油增强CT、对比增强MRI、术中超声以及超声引导下细针穿刺细胞学检查和活检。在生存和肿瘤消退方面带来了一定改善的治疗选择包括手术切除、原位肝移植、经皮乙醇注射、动脉化疗栓塞、冷冻疗法以及全身或局部化疗。尽管有这些进展，但HCC的诊断仍然预示着预后不佳。
