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肝细胞癌
Hepatocellular Carcinoma


Augusto Villanueva ... 肿瘤 • 2019.04.11
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肝细胞癌占原发性肝癌的大多数。在全球范围内,肝癌是癌症相关死亡的第四大原因,在新发病例数量方面排名第六1。根据年度预测,世界卫生组织估计,2030年将有超过100万患者死于肝癌2。在美国,2000—2016年,肝癌死亡率增加了43%(从每10万人中有7.2人死亡增加至10.3人死亡)3。肝癌的5年生存率为18%,是胰腺癌之后排名第二的致死性肿瘤4。大多数肝细胞癌发生于有基础肝病的患者,主要是由乙型或丙型肝炎病毒(HBV或HCV)感染或者酒精滥用导致。HBV疫苗的普遍接种及抗HCV的直接抗病毒药的广泛应用可能改变肝细胞癌的病因学格局。然而,非酒精性脂肪性肝病的增多与代谢综合征和肥胖一起增加了肝癌的风险,非酒精性脂肪性肝病将很快成为西方国家肝癌的主要原因5。人种和族群差异在生存概率方面起着重要作用,黑种人和西班牙语裔接受根治的可能性比白种人低6。晚期肝癌患者的全身性治疗正在迅速发生改变,过去2年中有4种新药在3期试验中显示出临床疗效7。本文综述了肝细胞癌的主要基因改变、重要流行病学特征和循证治疗方法。





作者信息

Augusto Villanueva, M.D., Ph.D.
From the Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Tisch Cancer Institute, Graduate School of Biomedical Sciences, and the Division of Hematology and Medical Oncology, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York. Address reprint requests to Dr. Villanueva at the Division of Liver Diseases, 1425 Madison Ave., Box 1123, Rm. 11-70E, New York, NY 10029, or at augusto.villanueva@mssm.edu.

 

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