非肝硬化肝细胞癌：综合评述。

StephenW

World J Hepatol. 2019 Jan 27;11(1):1-18. doi: 10.4254/wjh.v11.i1.1.
Hepatocellular carcinoma in non-cirrhotic liver: A comprehensive review.
Desai A1, Sandhu S2, Lai JP3, Sandhu DS4.
Author information

1
    Department of Internal Medicine, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH 44109, United States.
2
    Department of Hematology and Oncology, Cleveland Clinic/Akron General Medical Center, Akron, OH 44307, United States.
3
    Department of Pathology, University of Florida, Gainsville, FL 32611, United States.
4
    Division of Gastroenterology and Hepatology, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH 44109, the United States. [email protected].

Abstract

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide. Despite being the 6th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however, about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features, diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.
KEYWORDS:

Clinical features; Diagnostic modalities; Future directions; Hepatitis B; Hepatitis C; Hepatocellular carcinoma; Management strategies; Non-cirrhotic liver; Risk factors

PMID:
    30705715
PMCID:
    PMC6354117
DOI:
    10.4254/wjh.v11.i1.1

StephenW

世界J Hepatol。 2019年1月27日; 11（1）：1-18。 doi：10.4254 / wjh.v11.i1.1。
非肝硬化肝细胞癌：综合评述。
Desai A1，Sandhu S2，Lai JP3，Sandhu DS4。
作者信息

1
    凯斯西储大学内科，美国俄亥俄州克利夫兰市MetroHealth医疗中心44109。
2
    美国俄亥俄州阿克伦市，克利夫兰诊所/阿克伦综合医疗中心，血液肿瘤科，44307。
3
    佛罗里达大学病理学系，Gainsville，FL 32611，United States。
4
    凯斯西储大学/ MetroHealth医疗中心，美国俄亥俄州克利夫兰44109，消化内科和肝病学科。 [email protected]。

抽象

肝细胞癌（HCC）是最常见的原发性肝癌类型，其反过来占全世界第六大常见癌症。尽管是第六位最常见的癌症，但它仍是癌症相关死亡的第二大原因。 HCC通常出现在肝硬化的背景中，然而，大约20％的病例可以在非肝硬化肝脏中发展。这个特定的HCC亚组通常处于晚期阶段，因为在非肝硬化肝脏中不进行监测。由于缺乏症状和监测成像，非肝硬化患者的HCC在其早期阶段是临床沉默的;该人群中肝脏储备较高。有趣的是，非酒精性脂肪性肝病，乙型肝炎病毒和丙型肝炎病毒感染中的F3纤维化与发生HCC的高风险相关。尽管在该实体的管理方面取得了相当大的进展，但迫切需要在患病人群中实施监测策略，以减少患者的疾病负担并改善这些患者的预后。本综合评述详述了非肝硬化患者HCC的流行病学，危险因素，临床特征，诊断和治疗，并为研究提供了未来发展方向。
关键词：

临床表现;诊断方式;未来发展方向;乙型肝炎;丙型肝炎;肝细胞癌;管理策略;非肝硬化肝;风险因素

结论：
    30705715
PMCID：
    PMC6354117
DOI：
    10.4254 / wjh.v11.i1.1