Hepatocellular carcinoma diagnosis and treatment: An overview.
Hepatocellular carcinoma diagnosis and treatment: An overview.
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DOI：
10.1016/j.livres.2020.11.006
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Wan YY
中科院分区：
文献类型：
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作者：
Colquhoun SD;Wan YY
几十年来，慢性肝病仍然是一个日益严重的全球健康威胁。尽管有疫苗和抗病毒疗法，乙型肝炎和丙型肝炎仍然是巨大的临床问题。肝脂肪变性已成为世界范围内迅速增长的一个问题，可以适当地描述为一种不断演变的流行病。 1 世界各地的酒精消费量呈上升趋势，而自身免疫性疾病和环境毒素都继续加剧这一看似普遍的健康困境。慢性肝病的共同点是进行性肝脏炎症，导致纤维化和肝硬化。尽管提高认识和改进诊断可能有益于肝病的整体管理，但具有讽刺意味的是，如果没有具体的定向调查，这些疾病可能会悄无声息地闷烧，并在数年中不被发现。未经控制的慢性肝病的典型例子，也可能是最具破坏性的后果是肝细胞癌（HCC）的发展。随着慢性肝病的增加，肝癌的发病率也在增加，肝癌现已成为全球癌症相关死亡最常见的原因之一。 1可用于治疗 HCC 患者的选择非常有限。 2007年，经过多年的努力，蛋白激酶抑制剂索拉非尼被证明可以有效治疗不可切除的肝癌。 2 这是第一个被批准用于治疗原发性肝癌的全身药物疗法，也是当时唯一能够显着提高 HCC 患者总生存率的药物。这第一次使 HCC 从孤儿疾病的阴影中消失，并为 HCC 患者带来了希望之光。不幸的是，这种药物不足以成为真正有效的治疗方法，只能提供数周的生存获益，同时还增加了极高的成本。尽管如此，这一早期的成功无疑激发了新的投资，并重新激发了研究人员的热情，以找到战胜这种令人沮丧的疾病所需的答案。付出巨大的努力
For decades, chronic liver disease has remained an increasing global health threat. Despite vaccines and antiviral therapies, both hepatitis B and C remain enormous clinical problems. Hepatic steatosis has become a rapidly increasing worldwide concern that can be appropriately characterized as an evolving epidemic. 1 Around the world alcohol consumption is on the rise, while autoimmune conditions and environmental toxins all continue contributing to this seemingly universal health dilemma. The common denominator of chronic liver disease is progressive hepatic inflammation leading to fibrosis and cirrhosis. Although increased awareness and improved diagnostics may be beneficial in the management of liver disease overall, it remains ironic that without specific directed investigations, these conditions can smolder silently and progress undetected for years. The prime example and likely the most devastating consequence of unchecked chronic liver disease is the development of hepatocellular carcinoma (HCC). As chronic liver disease has increased, so too has the incidence of HCC, which has now become one of the most common global causes of cancer-related deaths. 1The options available for treating patients with HCC have been exceptionally limited. In 2007, after years of effort, a protein kinase inhibitor sorafenib was shown to be effective in the treatment of unresectable HCC. 2 This was the first systemic drug therapy approved for the treatment of primary liver cancer and the only drug, at that point, with the efficacy to significantly improve overall survival for patients with HCC. For the first time, this removed HCC from the shadows of an orphan disease and into the light of hope for HCC patients. Unfortunately, this drug falls short of a truly effective therapy, offering survival benefits measured only in weeks while adding exceptionally high costs. Nevertheless, this earlier success no doubt inspired new investment and renewed enthusiasm for researchers to find the answers necessary to conquer this otherwise demoralizing disease. Enormous efforts