慢性病毒性肝炎中的肝细胞癌：我们站在哪里？

StephenW

慢性病毒性肝炎中的肝细胞癌：我们站在哪里？
Francesco Paolo Russo 1 , Alberto Zanetto 1 , Elisa Pinto 1 , Sara Battistella 1 , Barbara Penzo 1 , Patrizia Burra 1 , Fabio Farinati 1
隶属关系
联系

    1
    意大利帕多瓦 35128 帕多瓦大学医院外科、肿瘤学和胃肠病学部胃肠病学/多脏器移植科。

    PMID：35008926 DOI：10.3390/ijms23010500

抽象的

肝细胞癌（HCC）是癌症相关死亡的主要原因之一。尽管酒精和 NASH 相关 HCC 的负担正在增加，但慢性病毒性肝炎（HBV 和 HCV）仍然是全球 HCC 发展的主要原因。病毒相关 HCC 的病理生理学包括肝脏炎症、氧化应激和细胞信号通路的失调。 HBV 特别具有致癌性，因为与 HCV 不同，它整合在细胞 DNA 中，并且尽管受到核苷酸类似物的病毒学抑制，但仍然存在。建议肝硬化患者和慢性 HBV 感染的“高危”患者进行为期 6 个月的超声监测。抗病毒治疗可降低 HCC 发生和复发的风险；然而，尽管病毒学抑制/治愈，晚期慢性肝病患者仍有发生 HCC 的风险，因此应继续监测。已经在慢性乙型肝炎患者中开发了多种评分来预测 HCC 发展的风险，并可用于对个体患者的风险进行分层。在通过直接作用的抗病毒药物获得持续病毒学应答的 HCV 相关肝病患者中，强烈需要标志物/评分来预测 HCC 的长期风险。在这篇综述中，我们讨论了有关病毒相关 HCC 的最新进展。

关键词：乙肝；丙肝病毒；肝硬化;肝细胞癌;生存。
出版物类型

    审查

StephenW

Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
Francesco Paolo Russo  1 , Alberto Zanetto  1 , Elisa Pinto  1 , Sara Battistella  1 , Barbara Penzo  1 , Patrizia Burra  1 , Fabio Farinati  1
Affiliations
Affiliation

    1
    Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, Italy.

    PMID: 35008926 DOI: 10.3390/ijms23010500

Abstract

Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related death. Although the burden of alcohol- and NASH-related HCC is growing, chronic viral hepatitis (HBV and HCV) remains a major cause of HCC development worldwide. The pathophysiology of viral-related HCC includes liver inflammation, oxidative stress, and deregulation of cell signaling pathways. HBV is particularly oncogenic because, contrary to HCV, integrates in the cell DNA and persists despite virological suppression by nucleotide analogues. Surveillance by six-month ultrasound is recommended in patients with cirrhosis and in "high-risk" patients with chronic HBV infection. Antiviral therapy reduces the risks of development and recurrence of HCC; however, patients with advanced chronic liver disease remain at risk of HCC despite virological suppression/cure and should therefore continue surveillance. Multiple scores have been developed in patients with chronic hepatitis B to predict the risk of HCC development and may be used to stratify individual patient's risk. In patients with HCV-related liver disease who achieve sustained virological response by direct acting antivirals, there is a strong need for markers/scores to predict long-term risk of HCC. In this review, we discuss the most recent advances regarding viral-related HCC.

Keywords: HBV; HCV; cirrhosis; hepatocellular carcinoma; survival.
Publication types

    Review