Hepatitis C virus-induced hepatocellular carcinoma.
Hepatitis C virus-induced hepatocellular carcinoma.
复制标题
DOI：
10.3350/cmh.2015.21.2.105
复制
发表时间：
2015-06
影响因子：
8.9
通讯作者：
Hoshida Y
中科院分区：
文献类型：
--
作者：
Goossens N;Hoshida Y
丙型肝炎病毒（HCV）是肝细胞癌（HCC）的主要病因。HCV与其人类宿主的相互作用是复杂和多层次的;部分源于HCV是RNA病毒，不能整合到宿主基因组中的事实。HCV诱导HCC的直接和间接机制包括多种宿主途径的激活，如肝纤维化途径、细胞和存活途径、与免疫和代谢系统的相互作用。宿主因素也在HCV诱导的HCC中起主要作用，如通过基因组研究鉴定的与HCC风险增加相关的免疫、代谢和生长信号系统的多态性所证明的。尽管有高效的直接作用的抗病毒药物，但HCV的肝脏相关并发症（包括HCC）的发病率和发病率在不久的将来可能会持续下去。已经报道了选择性识别HCC风险较高的HCV受试者的临床标志物，但它们需要进一步验证，特别是在经历持续病毒学应答的受试者中。允许进一步细化HCC风险的分子生物标志物开始在临床平台中实施，允许对风险进行客观分层，并导致HCV个体的个体化治疗和监测。基于分子生物标志物的分层的另一个作用可能是丰富HCC化学预防临床试验，从而减少样本量，缩短试验持续时间并降低成本。
Hepatitis C virus (HCV) is a leading etiology of hepatocellular carcinoma (HCC). The interaction of HCV with its human host is complex and multilayered; stemming in part from the fact that HCV is a RNA virus with no ability to integrate in the host's genome. Direct and indirect mechanisms of HCV-induced HCC include activation of multiple host pathways such as liver fibrogenic pathways, cellular and survival pathways, interaction with the immune and metabolic systems. Host factors also play a major role in HCV-induced HCC as evidenced by genomic studies identifying polymorphisms in immune, metabolic, and growth signaling systems associated with increased risk of HCC. Despite highly effective direct-acting antiviral agents, the morbidity and incidence of liver-related complications of HCV, including HCC, is likely to persist in the near future. Clinical markers to selectively identify HCV subjects at higher risk of developing HCC have been reported however they require further validation, especially in subjects who have experienced sustained virological response. Molecular biomarkers allowing further refinement of HCC risk are starting to be implemented in clinical platforms, allowing objective stratification of risk and leading to individualized therapy and surveillance for HCV individuals. Another role for molecular biomarker-based stratification could be enrichment of HCC chemoprevention clinical trials leading to smaller sample size, shorter trial duration, and reduced costs.