Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis.
Review of hepatocellular carcinoma: Epidemiology, etiology, and carcinogenesis.
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DOI：
10.4103/jcar.jcar_9_16
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发表时间：
2017
影响因子：
--
通讯作者：
Rowe JH
中科院分区：
文献类型：
--
作者：
Ghouri YA;Mian I;Rowe JH
自20世纪70年代以来，肝细胞癌的流行已经超越了东亚的优势，并在北半球特别是美国和西欧呈上升趋势。它更多地发生在男性的40岁和50岁。在所有癌症中，肝癌是美国增长最快的死亡原因之一，并对医疗保健造成重大经济负担。由乙肝病毒或丙型肝炎病毒和酒精引起的慢性肝病占大多数肝细胞癌病例。非酒精性脂肪性肝病的发病率呈上升趋势，并与肝细胞癌的发生发展密切相关。尽管大多数病例发生在背景肝硬变的背景下，但其发病机制因潜在的病因而异。肝细胞癌的发生包括血管生成、慢性炎症、肿瘤宏观环境和微环境。内在的遗传风险因素和外在的影响，如酒精或病毒感染，都在导致肝细胞癌的发展中起着重要的作用。了解其发病机制有助于选择适当的诊断测试和治疗方法。
Since the 1970s, the epidemic of hepatocellular carcinoma (HCC) has spread beyond the Eastern Asian predominance and has been increasing in Northern hemisphere, especially in the United States (US) and Western Europe. It occurs more commonly in males in the fourth and fifth decades of life. Among all cancers, HCC is one of the fastest growing causes of death in the US and poses a significant economic burden on healthcare. Chronic liver disease due to hepatitis B virus or hepatitis C virus and alcohol accounts for the majority of HCC cases. Incidence of nonalcoholic fatty liver disease has been on the risem and it has also been associated with the development of HCC. Its pathogenesis varies based on the underlying etiological factor although majority of cases develop in the setting of background cirrhosis. Carcinogenesis of HCC includes angiogenesis, chronic inflammation, and tumor macroenvironment and microenvironment. There is a significant role of both intrinsic genetic risk factors and extrinsic influences such as alcohol or viral infections that lead to the development of HCC. Understanding its etiopathogenesis helps select appropriate diagnostic tests and treatments.