The Etiology of Hepatocellular Carcinoma and Consequences for Treatment
The Etiology of Hepatocellular Carcinoma and Consequences for Treatment
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DOI：
10.1634/theoncologist.2010-s4-14
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发表时间：
2010-11-01
期刊：
影响因子：
5.8
通讯作者：
Lencioni, Riccardo
中科院分区：
文献类型：
--
作者：
Sanyal, Arun J.;Yoon, Seung Kew;Lencioni, Riccardo
大多数肝细胞癌（HCC）患者患有肝硬化，其在长期慢性肝病后发展。肝硬化的特征在于肝细胞增殖减少，表明肝脏再生能力耗尽，并导致纤维组织增加和肝细胞破坏，这可能最终导致癌性结节的发展。所有HCC病例中有一半与B型肝炎病毒感染有关，另外25%与丙型肝炎病毒有关。发展HCC的其他风险因素包括酒精性肝病、非酒精性脂肪性肝炎、摄入黄曲霉毒素污染的食物、糖尿病和肥胖。HCC的病因涉及多种因素，所有这些因素都对患者的特征和病程有直接影响，尽管通常可以确定致病因子，但HCC仍然是一种与预后不良相关的极其复杂的疾病。此外，病原学的地理差异意味着需要来自不同国家的信息，以优化监测方法并制定有效的化学预防策略。不幸的是，我们目前的理解仍然存在许多差距，需要进一步的研究努力来充分阐明HCC发病机制中涉及的各种机制，并为高危人群提供最佳预防策略。肿瘤学家2010; 15（增刊4）：14-22
Most patients with hepatocellular carcinoma (HCC) have liver cirrhosis, which develops following long periods of chronic liver disease. Cirrhosis is characterized by a decrease in hepatocyte proliferation, indicating an exhaustion of the regenerative capacity of the liver, and results in an increase in fibrous tissue and a destruction of liver cells, which may ultimately lead to the development of cancerous nodules. Half of all cases of HCC are associated with hepatitis B virus infection, with a further 25% associated with hepatitis C virus. Other risk factors for developing HCC include alcoholic liver disease, nonalcoholic steatohepatitis, intake of aflatoxin-contaminated food, diabetes, and obesity. There are multiple factors involved in the etiology of HCC, all of which have a direct impact on patient characteristics and disease course, and although a causative agent can often be identified, HCC remains an extremely complex condition associated with a poor prognosis. Additionally, the geographic variation in etiology means that information from different countries is needed in order to optimize surveillance methods and develop effective chemoprevention strategies. Unfortunately, there are still many gaps in our current understanding, and further research efforts are needed to fully elucidate the diverse mechanisms involved in the pathogenesis of HCC and offer optimal prevention strategies for those at risk. The Oncologist 2010; 15(suppl 4): 14-22