Hepatocellular carcinoma
Hepatocellular carcinoma
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DOI：
10.1097/01.mog.0000159817.55661.ca
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发表时间：
2005-05-01
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
回顾的目的肝细胞癌（HCC）的发病率预计将继续增加，在未来二十年。肝癌发生的危险因素尚不清楚，肝癌的诊断标准也缺乏标准化。我们的目的是审查最新的信息有关的危险因素，监测和诊断，这种tumor.Recent调查结果酒精，烟草，肥胖，糖尿病和病毒病因相互作用，共同增加肝硬化患者的肝细胞癌的风险，这可能使我们能够确定一个高，肝硬化患者中肝癌的风险组。几项研究表明，监测腹泻患者具有成本效益，并导致生存率的总体改善。今年，美国器官共享联合网络的一项研究表明，30%的患者在移植前成像时分期不足，31%的诊断为1期HCC（直径< 2 cm的单个病灶）的患者在取出检查时没有肿瘤。另一项研究表明，动脉增强病变的洗脱是非常敏感和特异性的HCC的诊断。摘要不是所有的肝硬化患者有一个平等的发展为肝细胞癌的风险。因此，进一步的研究应该对HCC的风险进行分层，以便针对风险最高的患者进行监测。HCC诊断标准的标准化对于更好的患者护理和未来的研究至关重要。肝动脉内强化病灶的洗脱应作为肝细胞癌的重要诊断标准。
Purpose of review The incidence of hepatocellular carcinoma (HCC) is expected to continue to increase over the next two decades. The risk factors,for the development of HCC are unknown and there is a lack of standardization of the diagnostic criteria for HCC. Our aim is to review the latest information regarding the risk factors, surveillance and diagnosis of this tumor.Recent findings Alcohol, tobacco, obesity, diabetes and viral etiology interact together to increase the risk of hepatocellular carcinoma in patients with cirrhosis, which may allow us to identify a high, risk group for HCC among patients with, cirrhosis. Several studies showed that surveillance of cirrhotic patients is cost effective and leads to an overall improvement in survival. This,,year a study from the United Network of Organ Sharing in the United States indicated that 30% of patients were understaged by imaging pre-transplant and 31% of patients with a diagnosis of stage 1 HCC (single lesion < 2 cm in diameter) did not have a tumor on the explant examination. Another study showed that washout of arterially enhancing lesions is very sensitive and specific for a diagnosis of HCC.Summary Not all patients with cirrhosis have an equal risk for developing hepatocellular carcinoma. Therefore, further studies should stratify the risk of HCC so surveillance is tailored to those at the highest risk. Standardization of the,diagnostic criteria of HCC is critically important for better patient care and future research. Washout of arterially,enhancing, lesions should be important criteria of HCC.