小肝癌诊治研究最新进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v6i5.10100
Abstract
肝癌是全球癌症负担的主要因素,近几十年来,这种疾病的发病率在许多国家都有所上升。慢性乙型肝炎病毒(HBV)感染和黄曲霉毒素B1(AFB1)是中国和印度等发展中国家肝癌的主要危险因素。在发达国家,肝细胞癌(HCC)主要与丙型肝炎病毒(HCV)感染及非酒精性脂肪性肝病(NAFLD)所导致的肝硬化相关。肝细胞癌(HCC)是肝癌的主要组织学类型,占肝癌诊断和死亡的绝大多数,严重威胁着人类的生命和健康。随着对健康体检的重视及影像学技术的发展,原发性小肝癌的检出率逐步增高。过去认为 sHCC的首选治疗是肝移植和肝切除术,但随着医学技术的蓬勃发展,sHCC的治疗方法也呈现多样化。本文主要结合国内外sHCC治疗研究进展作一综述。
Keywords
小肝癌；根治性治疗；手术治疗；消融；肝移植；放射治疗
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[1] Rumgay, Harriet et al.“Global burden of primary liver cancer in 2020 and predictions to 2040.” Journal of hepato logy vol.77,6(2022):1598-1606.
[2] The Society of Liver Cancer,China Anti-Cancer Associa tion.中国肿瘤整合诊治指南(CACA)-肝癌部分.肿瘤综合治疗电子杂志8.03(2022):31-63.
[3] CONG WM,WU MC.Small hepatocellular carcinoma: current and future approaches[J].Hepatol Int,2013,7(3):805－812.
[4] 中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)[J].临床肝胆病杂志,2011,27(11):1141-1159.
[5] LUXY,XIT,LAUWY,etal．Pathobiological features of small hepatocellular carcinoma: correlation between tumor size and biological behavior[J].J Cancer Ｒes Clin Oncol,2011,137( 4) :567－575.
[6] MOＲIBE T,IIZUKA N,MIUＲA T,et al.Methylation of mult iple genes as molecular markers for diagnosis of a small,welldifferentiated hepatocellular carcinoma[J].IntJCancer,2009,125(2):388-397.
[7] LLOVETJM,CHENY,WUＲMBACHE,etal．Amolecularsignature to discriminate dysplastic nodules from early hepatocellular carcinoma in HCV cirrhosis[J].Gastroenterology,2006,131(6): 1758-1767.
[8] UENOS,KUBOF,SAKODAM,etal.Efficacyof anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification[J].JHepatobiliaryPanc reatSurg,2008,15(5):493－500.
[9] Benson,AlBetal.“HepatobiliaryCancers,Version2.2021, NCCN Clinical Practice Guidelines in Oncology.” Journal of the National Comprehensive Cancer Network: JNCCvol.19,5541-565.1May.2021,
[10] 原发性肝癌诊疗指南 (2022年版 )[J].浙江实用医学,2022,27(06):528-536.
[11] Jiao,Shoufeietal.“Anatomic versus non-anatomic re section for hepatocellular carcinoma, do we have an answer? A meta-analysis.” International journal of surgery(London, England)vol.80(2020):243-255.doi:10.1016/j.ijsu.2020.05.008.
[12] Moris, Dimitrios etal.“Anatomic versus non-anatom ic resection for hepatocellular carcinoma: A systematic review and meta-analysis.” European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology vol. 44,7 (2018):927-938.
[13] El-Gendi, Ahmed et al.“Laparoscopic Versus Open Hepatic Resection for Solitary Hepatocellular Carcinoma Less Than 5 cm in Cirrhotic Patients: A Randomized Controlled Study.” Journal of laparoendoscopic & advanced surgical techniques. Part A vol. 28,3(2018):302-310.
[14] Lau WY, Lai ECH.Loco-regional intervention for hepa tocellular carcinoma. J Interv Med. 2019 Jul 30;2(2):43-46. doi: 10.1016/j.jimed.2019.07.001. Erratum in: J Interv Med. 2020 Nov 27;3(4):216.PMID:34805870;PMCID: PMC8562167.
[15] Llovet, Josep M, and Jordi Bruix. “Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival.” Hepatology (Baltimore, Md.)vol.37,2(2003):429-42.doi:10.1053/jhep.2003.50047.
[16] H.-F. Hu, Y.-F. Sang.A real-world study of Chinese hepatocellular carcinoma patients treated with TACE Eur Rev Med Pharmacol Sci.Year:2022.Vol.26-N.9.Pages:3091-3099.
[17] Lee, Moonhyung, and Hyun Phil Shin. “Efficacy of Transarterial Chemoembolization (TACE) for Early-Stage Hepa tocellular Carcinoma.” Medicina (Kaunas, Lithuania) vol. 59,122174.14 Dec.2023,doi:10.3390/medicina59122174.
[18] Xu,Haishan et al. “The effects of ultrasound-guided radiofrequency ablation and laparoscopic hepatectomy in the treatment of small hepatocellular carcinoma: a retrospectiveanalysis.”Translational cancer research vol.10,11(2021): 4794-4801.
[19] Jianyong, Lei etal.“Comparison of open liver resect ion and RFA for the treatment of solitary 3-5-cmhepatocell ular carcinoma: a retrospective study.”BMC surgervol. 19,1 195.16 Dec.2019,doi:10.1186/s12893-019-0663-9.
[20] Chen J, Peng K, Hu D, Shen J, Zhou Z, Xu L, et al. Tumor location influences oncologic outcomes of hepatocellular carcinoma patients undergoing radiofrequency ablation.Cance rs (Basel)2018;10(10):378. doi:10.3390/cancers10100378.
[21] 王君.超声引导下经皮微波消融术对原发性小肝癌患者肝功能的影响分析[J].中国医学工程,2021,29(11):113-115.
[22] RyanTGroeschl,CharlesHCPilgrim,Erin M Hanna,et al. Microwave Ablation for Hepatic Malignancies: A Multiinstit utional Analysis[J].Annals of Surgery,2014,259(6):1195-1200.
[23] 龚军,路翔宇,许建等.经皮微波消融术与腹腔镜肝癌切除术治疗小肝癌的临床疗效观察[J].中国社区医师,2020,36(06):13-14.
[24] Yu,Qian etal.“Percutaneous microwave ablation versus radiofrequency ablation of hepatocellular carcinoma: a meta -analysis of randomized controlled trials.”Abdominal radiol ogy(New York)vol.46,9(2021):4467-4475.
[25] HALAZUN KJ,NAJJAR M,ABDELMESSIH RM,etal. Recurrence after Liver Transplantation for hepatocellular carcinoma:A New MORAL to the Story[J].Ann Surg,2017,265(3):557-564.
[26] Drefs, Moritz et al."Changes in long-term survival after hepatocellular carcinoma resection and liver transplan tation over time: a meta-analysis." European Journal of Surg ical Oncology: Journal of the European Society of Surgical Oncology and the British Society of Surgical Oncology Vol. 50, No.3(2024):107952.
[27] European Association for the Study of the Liver. Email address:easloffice@easloffice.eu European Association for the Study of the Liver. "EASL Clinical Practice Guidelines:Management of Hepatocellular Carcinoma." Journal of Hepato logy Vol.69,No.1(2018):182-236.
[28] Yao, Francis Y and Nicholas Fidel Man. "Reassessing the boundaries of liver transplantation for hepatocellular carcin oma: where do we stand in terms of tumor staging?" Hepatology (Baltimore,MD)Volume 63,Issue 3(2016):1014-25.
[29] Durand-Labrunie J., Baumann A.-S., Ayav A., Laurent V.,Boleslawski E.,Cattan S.,etal.Curative irradiation treatmentof hepatocellular carcinoma: a multicenter phase 2 trial.Int J Radiat Oncology∗Biology∗Physics.2020;107:116–125.
[30] Durand-Labrunie J., Baumann A.-S., Ayav A., Laurent V., Boleslawski E.,Cattan S.,etal.Curative irradiation treatme nt of hepatocellular carcinoma: a multicenter phase 2 trial. Int J Radiat Oncology∗Biology∗Physics.2020;107:116–125.
[31] Hara K.,Takeda A., Tsurugai Y., Saigusa Y., Sanuki N., Eriguchi T., et al. Radiotherapy for hepatocellular carcinoma results in comparable survival to radiofrequency ablation: a propensity score analysis.Hepatology.2019;69:2533-2545.
[32] Sanuki N., Takeda A., Oku Y., Mizuno T., Aoki Y., Eriguchi T.,etal.Stereotactic body radiotherapy for small hepatocellu lar carcinoma: a retrospective outcome analysis in 185 patie nts.Acta Oncologica.2014;53:399-404.
[33] Mathew A.S., Atenafu E.G., Owen D., Maurino C., Brade A., Brierley J., et al. Long term outcomes of stereotactic bodyradiation therapy for hepatocellular carcinoma without macro vascular invasion.Eur J Cancer.2020;134:41-51.
[34] Gresswell S., Tobillo R., Hasan S., Uemura T., Machado L.,Thai N.,etal.Stereotactic body radiotherapy used as a brid ge to liver transplant in patients with hepatocellular carcino ma and Child-Pugh score≥8cirrhosis.JRadiosurg SBRT.2018;5:261-267.
[35] Moore A.,Cohen-Naftaly M.,Tobar A.,Kundel Y.,Benjami nov O., Braun M., et al. Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable Hepatocellular carcinoma.Radiat Oncol.2017;12:163.
[36] Hong J.,Cao L.,Xie H.,Liu Y., Yu J., Zheng S. Stereotactic body radiation therapy versus radiofrequency ablation in patients with small hepatocellular carcinoma: a systematic review and meta-analysis.Hepatobiliary Surg Nutr.2021;10:623–630.
[37] Kim T.H.,Koh Y.H., Kim B.H., Kim M.J., Lee J.H., Park B.,et al. Proton beam radiotherapy vs. radiofrequency ablation for recurrent hepatocellular carcinoma: a randomized phase III trial.J Hepatol.2021;74:603–612.
[38] Pan C.C.,Kavanagh B.D.,Dawson L.A.,Li X.A.,Das S.K.,Miften M.,etal.Radiation-associated liver injury.Int J Radiat Oncol Biol Phys.2010;76:S94–S100.
[2] The Society of Liver Cancer,China Anti-Cancer Associa tion.中国肿瘤整合诊治指南(CACA)-肝癌部分.肿瘤综合治疗电子杂志8.03(2022):31-63.
[3] CONG WM,WU MC.Small hepatocellular carcinoma: current and future approaches[J].Hepatol Int,2013,7(3):805－812.
[4] 中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)[J].临床肝胆病杂志,2011,27(11):1141-1159.
[5] LUXY,XIT,LAUWY,etal．Pathobiological features of small hepatocellular carcinoma: correlation between tumor size and biological behavior[J].J Cancer Ｒes Clin Oncol,2011,137( 4) :567－575.
[6] MOＲIBE T,IIZUKA N,MIUＲA T,et al.Methylation of mult iple genes as molecular markers for diagnosis of a small,welldifferentiated hepatocellular carcinoma[J].IntJCancer,2009,125(2):388-397.
[7] LLOVETJM,CHENY,WUＲMBACHE,etal．Amolecularsignature to discriminate dysplastic nodules from early hepatocellular carcinoma in HCV cirrhosis[J].Gastroenterology,2006,131(6): 1758-1767.
[8] UENOS,KUBOF,SAKODAM,etal.Efficacyof anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification[J].JHepatobiliaryPanc reatSurg,2008,15(5):493－500.
[9] Benson,AlBetal.“HepatobiliaryCancers,Version2.2021, NCCN Clinical Practice Guidelines in Oncology.” Journal of the National Comprehensive Cancer Network: JNCCvol.19,5541-565.1May.2021,
[10] 原发性肝癌诊疗指南 (2022年版 )[J].浙江实用医学,2022,27(06):528-536.
[11] Jiao,Shoufeietal.“Anatomic versus non-anatomic re section for hepatocellular carcinoma, do we have an answer? A meta-analysis.” International journal of surgery(London, England)vol.80(2020):243-255.doi:10.1016/j.ijsu.2020.05.008.
[12] Moris, Dimitrios etal.“Anatomic versus non-anatom ic resection for hepatocellular carcinoma: A systematic review and meta-analysis.” European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology vol. 44,7 (2018):927-938.
[13] El-Gendi, Ahmed et al.“Laparoscopic Versus Open Hepatic Resection for Solitary Hepatocellular Carcinoma Less Than 5 cm in Cirrhotic Patients: A Randomized Controlled Study.” Journal of laparoendoscopic & advanced surgical techniques. Part A vol. 28,3(2018):302-310.
[14] Lau WY, Lai ECH.Loco-regional intervention for hepa tocellular carcinoma. J Interv Med. 2019 Jul 30;2(2):43-46. doi: 10.1016/j.jimed.2019.07.001. Erratum in: J Interv Med. 2020 Nov 27;3(4):216.PMID:34805870;PMCID: PMC8562167.
[15] Llovet, Josep M, and Jordi Bruix. “Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival.” Hepatology (Baltimore, Md.)vol.37,2(2003):429-42.doi:10.1053/jhep.2003.50047.
[16] H.-F. Hu, Y.-F. Sang.A real-world study of Chinese hepatocellular carcinoma patients treated with TACE Eur Rev Med Pharmacol Sci.Year:2022.Vol.26-N.9.Pages:3091-3099.
[17] Lee, Moonhyung, and Hyun Phil Shin. “Efficacy of Transarterial Chemoembolization (TACE) for Early-Stage Hepa tocellular Carcinoma.” Medicina (Kaunas, Lithuania) vol. 59,122174.14 Dec.2023,doi:10.3390/medicina59122174.
[18] Xu,Haishan et al. “The effects of ultrasound-guided radiofrequency ablation and laparoscopic hepatectomy in the treatment of small hepatocellular carcinoma: a retrospectiveanalysis.”Translational cancer research vol.10,11(2021): 4794-4801.
[19] Jianyong, Lei etal.“Comparison of open liver resect ion and RFA for the treatment of solitary 3-5-cmhepatocell ular carcinoma: a retrospective study.”BMC surgervol. 19,1 195.16 Dec.2019,doi:10.1186/s12893-019-0663-9.
[20] Chen J, Peng K, Hu D, Shen J, Zhou Z, Xu L, et al. Tumor location influences oncologic outcomes of hepatocellular carcinoma patients undergoing radiofrequency ablation.Cance rs (Basel)2018;10(10):378. doi:10.3390/cancers10100378.
[21] 王君.超声引导下经皮微波消融术对原发性小肝癌患者肝功能的影响分析[J].中国医学工程,2021,29(11):113-115.
[22] RyanTGroeschl,CharlesHCPilgrim,Erin M Hanna,et al. Microwave Ablation for Hepatic Malignancies: A Multiinstit utional Analysis[J].Annals of Surgery,2014,259(6):1195-1200.
[23] 龚军,路翔宇,许建等.经皮微波消融术与腹腔镜肝癌切除术治疗小肝癌的临床疗效观察[J].中国社区医师,2020,36(06):13-14.
[24] Yu,Qian etal.“Percutaneous microwave ablation versus radiofrequency ablation of hepatocellular carcinoma: a meta -analysis of randomized controlled trials.”Abdominal radiol ogy(New York)vol.46,9(2021):4467-4475.
[25] HALAZUN KJ,NAJJAR M,ABDELMESSIH RM,etal. Recurrence after Liver Transplantation for hepatocellular carcinoma:A New MORAL to the Story[J].Ann Surg,2017,265(3):557-564.
[26] Drefs, Moritz et al."Changes in long-term survival after hepatocellular carcinoma resection and liver transplan tation over time: a meta-analysis." European Journal of Surg ical Oncology: Journal of the European Society of Surgical Oncology and the British Society of Surgical Oncology Vol. 50, No.3(2024):107952.
[27] European Association for the Study of the Liver. Email address:easloffice@easloffice.eu European Association for the Study of the Liver. "EASL Clinical Practice Guidelines:Management of Hepatocellular Carcinoma." Journal of Hepato logy Vol.69,No.1(2018):182-236.
[28] Yao, Francis Y and Nicholas Fidel Man. "Reassessing the boundaries of liver transplantation for hepatocellular carcin oma: where do we stand in terms of tumor staging?" Hepatology (Baltimore,MD)Volume 63,Issue 3(2016):1014-25.
[29] Durand-Labrunie J., Baumann A.-S., Ayav A., Laurent V.,Boleslawski E.,Cattan S.,etal.Curative irradiation treatmentof hepatocellular carcinoma: a multicenter phase 2 trial.Int J Radiat Oncology∗Biology∗Physics.2020;107:116–125.
[30] Durand-Labrunie J., Baumann A.-S., Ayav A., Laurent V., Boleslawski E.,Cattan S.,etal.Curative irradiation treatme nt of hepatocellular carcinoma: a multicenter phase 2 trial. Int J Radiat Oncology∗Biology∗Physics.2020;107:116–125.
[31] Hara K.,Takeda A., Tsurugai Y., Saigusa Y., Sanuki N., Eriguchi T., et al. Radiotherapy for hepatocellular carcinoma results in comparable survival to radiofrequency ablation: a propensity score analysis.Hepatology.2019;69:2533-2545.
[32] Sanuki N., Takeda A., Oku Y., Mizuno T., Aoki Y., Eriguchi T.,etal.Stereotactic body radiotherapy for small hepatocellu lar carcinoma: a retrospective outcome analysis in 185 patie nts.Acta Oncologica.2014;53:399-404.
[33] Mathew A.S., Atenafu E.G., Owen D., Maurino C., Brade A., Brierley J., et al. Long term outcomes of stereotactic bodyradiation therapy for hepatocellular carcinoma without macro vascular invasion.Eur J Cancer.2020;134:41-51.
[34] Gresswell S., Tobillo R., Hasan S., Uemura T., Machado L.,Thai N.,etal.Stereotactic body radiotherapy used as a brid ge to liver transplant in patients with hepatocellular carcino ma and Child-Pugh score≥8cirrhosis.JRadiosurg SBRT.2018;5:261-267.
[35] Moore A.,Cohen-Naftaly M.,Tobar A.,Kundel Y.,Benjami nov O., Braun M., et al. Stereotactic body radiation therapy (SBRT) for definitive treatment and as a bridge to liver transplantation in early stage inoperable Hepatocellular carcinoma.Radiat Oncol.2017;12:163.
[36] Hong J.,Cao L.,Xie H.,Liu Y., Yu J., Zheng S. Stereotactic body radiation therapy versus radiofrequency ablation in patients with small hepatocellular carcinoma: a systematic review and meta-analysis.Hepatobiliary Surg Nutr.2021;10:623–630.
[37] Kim T.H.,Koh Y.H., Kim B.H., Kim M.J., Lee J.H., Park B.,et al. Proton beam radiotherapy vs. radiofrequency ablation for recurrent hepatocellular carcinoma: a randomized phase III trial.J Hepatol.2021;74:603–612.
[38] Pan C.C.,Kavanagh B.D.,Dawson L.A.,Li X.A.,Das S.K.,Miften M.,etal.Radiation-associated liver injury.Int J Radiat Oncol Biol Phys.2010;76:S94–S100.
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