Etiology, natural history and treatment of hepatocellular carcinoma
Etiology, natural history and treatment of hepatocellular carcinoma
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DOI：
10.1016/j.antiviral.2003.08.010
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发表时间：
2003-10-01
影响因子：
7.6
通讯作者：
Sangiovanni, A
中科院分区：
文献类型：
--
作者：
Colombo, M;Sangiovanni, A
肝细胞癌（HCC）与环境，饮食和生活方式因素有关。肝硬化和慢性携带B型肝炎病毒（HBV）的患者每年发生HCC的风险为3%。在有肝硬化证据和肝细胞增殖增加的组织学标志物的患者中，HCC风险特别高。此外，血小板减少、凝血酶原时间延长和年龄超过55岁也是HCC发生的预测因素。根据肝硬化的存在与否、肿瘤的数量和大小以及肝功能失代偿的程度来确定治疗方案。肝切除术是这少数肿瘤周围正常肝组织和肝功能保存良好的患者的主要干预措施。在这种情况下，累积5年生存率约为45%。肝移植（奥尔特）为偶然发现微小结节的HCC患者提供了长期存活率（5年时90%），为病毒性肝硬化和单次肝硬化患者提供了75%的长期存活率。
Hepatocellular carcinoma (HCC) is linked to environmental, dietary and lifestyle factors. Patients with cirrhosis and chronic carriage of hepatitis B virus (HBV) are at risk for HCC at annual rates of 3%. HCC risk is particularly high in patients with evidence of cirrhosis and histological markers of increased liver cell proliferation. In addition, thrombocytopenia, prolonged prothrombin time and over 55 years of age also predict the development of HCC. Treatment options are defined according to the presence or absence of cirrhosis, number and size of tumors, and degree of hepatic decompensation. Hepatic resection is the primary intervention for these few patients with tumor but surrounding normal liver tissue and well preserved hepatic function. Under such circumstances, the cumulative 5-year survival is approximately 45%. Liver transplantation (OLT) provides long term survivals (90% at 5 years) in patients with a HCC discovered by chance as a minute nodule and of 75% in patients with viral cirrhosis and a single