预防乙型肝炎相关的肝细胞癌

StephenW

Review article: the prevention of hepatitis B‐related hepatocellular carcinoma
C.‐L. Lin
J.‐H. Kao
https://doi.org/10.1111/apt.14683

The Handling Editor for this article was Professor Geoffrey Dusheiko, and this uncommissioned ... More

Ample evidence indicates an aetiological association of persistent hepatitis B virus (HBV) infection with hepatocellular carcinoma (HCC). Several viral, host and external risk factors for the development of HBV‐related HCC have been documented.
Aims

To summarise and discuss the risk stratification and the preventive strategies of HBV‐related HCC.
Methods

Recent published studies identified from PubMed were comprehensively reviewed. The key words included chronic hepatitis B, HBV, hepatocellular carcinoma, prevention and antiviral therapy.
Results

The incidence of HCC is extremely high in HBV hyperendemic areas. For HBV patients left untreated, significant risk factors for HCC include male gender, aging, advanced hepatic fibrosis, persistent serum transaminase elevation, specific HBV entry receptor (NTCP) genotype, PM2.5 exposure, HBeAg positivity, HBV genotype C/D/F, high proportion of core promoter mutation, pre‐S deletion, high serum levels of HBV DNA and HBsAg as well as co‐infection with HCV, HDV and HIV. Primary prevention of HBV‐related HCC can be achieved through universal HBV vaccination and anti‐viral prophylaxis for high viraemic mothers. The goal of secondary prevention has been reached by effective anti‐viral therapy to reduce the risk of HCC development in chronic hepatitis B patients. However, whether HCC is prevented or delayed deserves further examination. Finally, several studies confirmed the tertiary preventive effect of anti‐viral therapy in reducing risk of HCC recurrence after curative therapies.
Conclusions

Through the strategies of three‐level prevention, the global burden of HBV‐related HCC should decline over time and even be eliminated in conjunction with HBV cure.

StephenW

评论文章：预防乙型肝炎相关的肝细胞癌
C.-L.林
J.-H.花王
https://doi.org/10.1111/apt.14683

这篇文章的处理编辑是Geoffrey Dusheiko教授，并且这是未委任的...更多
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概要
背景

充足的证据表明持续的乙型肝炎病毒（HBV）感染与肝细胞癌（HCC）的病因学关联。有关HBV相关HCC发展的几种病毒，宿主和外部风险因素已有记载。
目标

总结和讨论HBV相关HCC的危险分层和预防策略。
方法

PubMed最近发表的研究得到了全面审查。关键词包括慢性乙型肝炎，HBV，肝癌，预防和抗病毒治疗。
结果

HBV高发区HCC的发病率非常高。对于未接受治疗的HBV患者，HCC的显着危险因素包括男性，老化，晚期肝纤维化，持续血清转氨酶升高，特异性HBV进入受体（NTCP）基因型，PM2.5暴露，HBeAg阳性，HBV基因型C / D / F ，核心启动子突变比例高，前S缺失，血清HBV DNA和HBsAg水平高以及与HCV，HDV和HIV共同感染。 HBV相关HCC的初步预防可以通过普遍的HBV疫苗接种和高病毒母亲的抗病毒预防来实现。通过有效的抗病毒治疗已经达到了二级预防的目标，以降低慢性乙型肝炎患者发生HCC的风险。然而，HCC是否被阻止或延迟值得进一步检查。最后，一些研究证实了抗病毒治疗在降低治愈性疗法后HCC复发风险方面的三级预防效果。
结论

通过三级预防战略，HBV相关肝癌的全球负担应随着时间的推移而下降，甚至在HBV治愈的同时被消除。

StephenW

https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14683