乙肝相关肝细胞癌防治的障碍与机遇

StephenW

Obstacles and opportunities in the prevention and treatment of HBV-related hepatocellular carcinoma
Yong Liao  1   2   3
Affiliations
Affiliations

    1
    Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing, PR China.
    2
    Institute for Viral Hepatitis, Chongqing Medical University, Chongqing, PR China.
    3
    Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, PR China.

    PMID: 32884983 PMCID: PMC7452511 DOI: 10.1016/j.gendis.2019.12.014

Abstract

Despite the tremendous progresses toward our understanding of the mechanisms of how liver cancer was developed, the therapeutic outcomes of liver cancer in the clinic have very limited improvement within the past three decades or so. In addition, both the incidence and mortality of liver cancer worldwide are not dropping, but increasing steadily, in the last decade. Thus, it is time for us to rethink what has been wrong and how could we do better in the upcoming years, in order to achieve our goal of improving the therapeutic outcomes of patients with liver cancer in the clinic, and at the meantime, effectively reducing the incidence of liver cancer by blocking malignant transformation of hepatocytes from chronic viral infection. This is also one of the main reasons why we try to organize this special issue on primary liver cancer in the journal of Genes & Diseases. In this perspective, I will summarize the major obstacles confronted with in the prevention and management of patients with chronic hepatitis B infection and subsequent development of liver cirrhosis and liver cancer. Next, I will delineate the pitfalls and underlying mechanisms of why the current anti-viral strategies and therapeutic agents are not as effective as one expected in terms of successful reduction or prevention chronic hepatitis B infection associated liver cirrhosis and liver cancer. I will then provide my personal perspectives on potential approaches and strategies for effective prevention and management of hepatitis B-related liver cancer.

Keywords: AFP, alpha-fetoprotein; Anti-viral therapy; Chronic inflammation; DAA, Direct antiviral agents; HBV, Hepatitis B virus; HCC, Hepatocellular carcinoma; Liver cancer; Liver cirrhosis; Malignant transformation; NA, Nucleos(t)ide analogue; NAFLD, Non-alcoholic fatty liver diseases; NASH, Non-alcoholic steatohepatitis; OS, Overall Survival; cccDNA, covalently closed circular DNA.

© 2020 Chongqing Medical University. Production and hosting by Elsevier B.V.
Conflict of interest statement

The Author declares no conflict of interest.

StephenW

乙肝相关肝细胞癌防治的障碍与机遇
永辽1 2 3
隶属关系
隶属关系

    1个
    重庆市传染病分子生物学教育部重点实验室。
    2
    重庆医科大学病毒性肝炎研究所，中国重庆。
    3
    重庆医科大学附属第二医院传染病科，重庆。

    PMID：32884983 PMCID：PMC7452511 DOI：10.1016 / j.gendis.2019.12.014

抽象

尽管在我们对肝癌发生机理的理解上取得了巨大进步，但在过去的三十年左右的时间里，肝癌在临床上的治疗效果仍然非常有限。另外，在过去的十年中，全世界肝癌的发病率和死亡率都没有下降，而是稳步上升。因此，现在是我们重新思考问题所在以及在未来几年中如何做得更好的时候了，以实现我们在临床上同时有效地改善肝癌患者治疗效果的目标。通过阻止慢性病毒感染引起的肝细胞恶性转化来降低肝癌的发病率。这也是我们尝试在《基因与疾病》杂志上组织有关原发性肝癌的特刊的主要原因之一。从这个角度，我将总结在预防和管理慢性乙型肝炎患者以及随后发展为肝硬化和肝癌方面面临的主要障碍。接下来，我将描述为什么当前的抗病毒策略和治疗药物不能像成功地减少或预防与慢性乙型肝炎感染有关的肝硬化和肝癌那样有效的效果的陷阱和潜在机理。然后，我将就有效预防和管理乙型肝炎相关肝癌的潜在方法和策略发表个人看法。

关键词：AFP，甲胎蛋白；抗病毒治疗；慢性炎症; DAA，直接抗病毒药； HBV，乙型肝炎病毒； HCC，肝细胞癌；肝癌;肝硬化；恶性转化； NA，Nucleos（t）ide类似物； NAFLD，非酒精性脂肪肝疾病； NASH，非酒精性脂肪性肝炎； OS，总体生存率； cccDNA，共价闭合的环状DNA。

©2020重庆医科大学。 Elsevier B.V.的制作和托管
利益冲突声明

作者声明没有利益冲突。

StephenW

https://www.sciencedirect.com/sc ... 20300088?via%3Dihub