Hepatocellular carcinoma
Hepatocellular carcinoma
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DOI：
10.1097/01.mog.0000218961.86182.8c
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发表时间：
2006-05-01
影响因子：
2.5
通讯作者：
Marrero, JA
中科院分区：
文献类型：
--
作者：
Marrero, JA
综述目的我们的目的是回顾有关这种肿瘤类型的危险因素、早期检测、诊断和治疗标志物的最新信息。最近的研究结果酒精、烟草和肥胖相互作用，增加了肝细胞癌的风险，这可能使我们能够在肝硬化患者中识别出肝细胞癌的高危人群。一项肝细胞癌监测的随机对照试验首次显示，与未接受监测的患者相比，接受监测的患者的生存率有所提高。另一项研究表明，动脉增强病变的造影剂冲洗对于肝细胞癌是敏感且特异的。巴塞罗那临床肝癌分期分类最适合对肝细胞癌患者的预后和治疗策略进行分层。三项随机试验表明，与经皮乙醇注射相比，射频消融可提高早期肝细胞癌的生存率。总结并非所有肝硬化患者都具有相同的发生肝细胞癌的风险。进一步的研究应该对肝细胞癌的风险进行分层，以便针对风险最高的人群进行监测。动脉增强肿块造影剂洗刷被认为是肝细胞癌三相成像的典型表现。射频消融是治疗小肝细胞癌最好的消融技术。
Purpose of reviewOur aim is to review the latest information regarding the risk factors, markers for early detection, diagnosis, and therapy for this tumor type.Recent findingsAlcohol, tobacco, and obesity interact together to increase the risk of hepatocellular carcinoma, which may allow us to identify a high-risk group for hepatocellular carcinoma among patients with cirrhosis. For the first time, a randomized controlled trial of surveillance for hepatocellular carcinoma showed improved survival for those patients who underwent surveillance compared with no surveillance. Another study showed that washout of contrast of an arterially enhancing lesion is sensitive and specific for hepatocellular carcinoma. The Barcelona Clinic Liver Cancer staging classification is the best at stratifying prognosis and treatment strategy for patients with hepatocellular carcinoma. Three randomized trials showed that radiofrequency ablation improves survival when compared to percutaneous ethanol injection for early hepatocellular carcinoma.SummaryNot all patients with cirrhosis have an equal risk for developing hepatocellular carcinoma. Further studies should stratify the risk of hepatocellular carcinoma so surveillance is tailored to those at the highest risk. Washout of contrast of arterially enhancing mass is regarded as the typical appearance of hepatocellular carcinoma in triple-phase imaging. Radiofrequency ablation is the best ablative technique for the treatment of small hepatocellular carcinoma.