Bile acids as drivers and biomarkers of hepatocellular carcinoma.

Bile acids as drivers and biomarkers of hepatocellular carcinoma.
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胆汁酸是肝细胞癌的驱动因素和生物标志物。

DOI:
10.4254/wjh.v14.i9.1730
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发表时间:
2022-09-27
影响因子:
2.4
通讯作者:
Tomlinson JW
Tomlinson JW
中科院分区:
其他
文献类型:
--
作者:
Colosimo S;Tomlinson JW

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肝细胞癌(HCC)的患病率正在迅速增加,部分原因是非酒精性脂肪肝的患病率不断上升。胆汁酸(BA)谱在HCC患者中发生改变,并且来自体外人类细胞模型以及啮齿动物数据的证据越来越多,表明BA能够调节影响HCC发展易感细胞表型的基本过程,包括衰老,增殖和上皮-间充质转化。与HCC相关的BA谱的变化具有临床应用的潜力。虽然有很好的诊断和成像工具,但它们用于筛查有HCC风险的晚期肝病人群受到高成本和低可用性的限制。肝硬化受试者中HCC筛查的主要方法仍然是频繁的间隔超声扫描。重要的是,目前可用的血清生物标志物几乎没有增加诊断的准确性。在这里,我们回顾了目前的文献使用BA测量作为肝癌发病率的预测,除了他们作为一个潜在的筛查方法,早期发现肝癌。虽然这些方法确实显示出早期前景,但存在局限性,包括队列规模相对较小,缺乏标准化的BA测量方法,以及使用不适当的对照比较样本。
The prevalence of hepatocellular carcinoma (HCC) is rapidly increasing, driven not least in part by the escalating prevalence of non-alcoholic fatty liver disease. Bile acid (BA) profiles are altered in patients with HCC and there is a developing body of evidence from in vitro human cellular models as well as rodent data suggesting that BA are able to modulate fundamental processes that impact on cellular phenotype predisposing to the development of HCC including senescence, proliferation and epithelial-mesenchymal transition. Changes in BA profiles associated with HCC have the potential to be exploited clinically. Whilst excellent diagnostic and imaging tools are available, their use to screen populations with advanced liver disease at risk of HCC is limited by high cost and low availability. The mainstay for HCC screening among subjects with cirrhosis remains frequent interval ultrasound scanning. Importantly, currently available serum biomarkers add little to diagnostic accuracy. Here, we review the current literature on the use of BA measurements as predictors of HCC incidence in addition to their use as a potential screening method for the early detection of HCC. Whilst these approaches do show early promise, there are limitations including the relatively small cohort sizes, the lack of a standardized approach to BA measurement, and the use of inappropriate control comparator samples.
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