摘要
肝细胞癌(HCC)是全球癌症死亡的主要原因之一,HBV感染是HCC最重要的危险因素之一。HBV相关HCC的发生是宿主与病毒相互作用的复杂过程,危险因素包括HBV病毒载量、HBeAg、宿主易感性等。HCC筛查方式包括超声等影像学检查和AFP等血清标志物,血清异常凝血酶原Ⅱ和AFP异质体有助于诊断AFP阴性HCC。如果采取接种乙型肝炎疫苗、抗病毒治疗等合理措施,可以预防HCC发生。慢性乙型肝炎抗病毒治疗的长远目标在于减少并发症发生,包括肝硬化甚至HCC。核苷类药物抗病毒治疗可有效抑制病毒复制,但无法根除肝细胞核内的cccDNA,治愈乙型肝炎仍然迫在眉睫。综述了HBV相关HCC的流行病学、危险因素、筛查方法和预防策略。
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide and hepatitis B virus (HBV) infection is one of most important risk factors for HCC. The development of HBV-related HCC involves a complex interaction between host and virus, and related risk factors include HBV viral load, HBeAg, and host susceptibility. Screening methods for HCC include radiological examination such as ultrasound and serological markers such as α-fetoprotein, and protein induced by vitamin K antagonist-II and alpha-fetoprotein (AFP) variants may help with the diagnosis of AFP-negative HCC. Appropriate measures such as HBV vaccination and antiviral therapy can help to prevent HCC. The long-term goal of antiviral therapy for chronic hepatitis B is to reduce complications such as liver cirrhosis and HCC. nucleos(t)ide analogues can effectively inhibit replication of virus, but they cannot eradicate covalently closed circular DNA in the nucleus of hepatocytes. There is still an urgent need for a cure for hepatitis B. This article reviews the epidemiology, risk factors, screening methods, and preventive strategies for HBV-related HCC.
作者
李汨
聂青和
韩曼
鞠迪
LI Mi;NIE Qinghe;HAN Man(Shaanxi University of Chinese Medicine,Xianyang,Shaanxi 712046,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2019年第3期651-655,共5页
Journal of Clinical Hepatology
基金
陕西中医药大学基础医学院中西医结合基础心血管方向创新团队资助项目.
关键词
肝炎病毒
乙型
癌
肝细胞
危险因素
综合预防
综述
hepatitis B virus
carcinoma, hepatocellular
risk factors
universal precautions
review
