New strategies in hepatocellular carcinoma: genomic prognostic markers.
New strategies in hepatocellular carcinoma: genomic prognostic markers.
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DOI：
10.1158/1078-0432.ccr-09-1811
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发表时间：
2010-10-01
期刊：
影响因子：
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通讯作者：
Llovet JM
中科院分区：
文献类型：
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作者：
Villanueva A;Hoshida Y;Toffanin S;Lachenmayer A;Alsinet C;Savic R;Cornella H;Llovet JM
准确的肿瘤预后预测是至关重要的。在肝细胞癌（HCC）患者中，与大多数实体瘤不同，两种危及生命的疾病（如癌症和肝硬化）的共存难以进行预后评估。尽管HCC的临床分期系统在常规临床决策中是有用的（例如，尽管如此，仍然需要改进和补充结果预测。最近的数据表明来自肿瘤的基因签名的能力（例如，EpCAM标记）和邻近组织（例如，低生存率特征）来预测HCC的结果（复发或总生存率），尽管仍需要独立的外部验证。此外，新的信息正在产生的替代基因组来源，如miRNA（例如，miR-26 a）或表观基因组学，其中有希望的初步数据被彻底探索的领域。预后模型需要考虑肝功能障碍的影响和患者预期寿命中随后新发肿瘤的风险。未来几年的挑战将是精确描述基因组预测因子（例如，基因签名、miRNA或表观遗传生物标志物）及其特定影响来确定患者预后。
Accurate prognosis prediction in oncology is critical. In patients with hepatocellular carcinoma (HCC), unlike most solid tumors, coexistence of two life-threatening conditions such as cancer and cirrhosis difficult prognostic assessments. Despite the usefulness of clinical staging systems for HCC in routine clinical decision-making (e.g., Barcelona-Clinic Liver Cancer algorithm), there is still need to refine and complement outcome predictions. Recent data suggest the ability of gene signatures from the tumor (e.g., EpCAM signature) and adjacent tissue (e.g., poor-survival signature) to predict outcome in HCC (either recurrence or overall survival), although independent external validation is still required. In addition, novel information is being produced by alternative genomic sources such as miRNA (e.g., miR-26a) or epigenomics, areas in which promising preliminary data is thoroughly explored. Prognostic models need to contemplate the impact of liver dysfunction and risk of subsequent de novo tumors in patient’s life expectancy. The challenge for upcoming years will be to precisely depict genomic predictors (e.g., gene signatures, miRNA or epigenetic biomarkers) at each stage of the disease and their specific influence to determine patient prognosis.