切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (01) : 22 -28. doi: 10.3877/cma.j.issn.2095-3232.2023.01.005

所属专题: 述评 综述

专家论坛

肝细胞癌早期诊断和筛查
丁成明1, 侯嘉丰1, 陶光伟1, 齐硕1, 谢翼1, 冯灿1, 陈振坤1, 蒋心渺1, 邓鑫1, 彭健2,()   
  1. 1. 421001 湖南省衡阳市南华大学附属第一医院肝胆胰外科
    2. 410008 湖南省长沙市中南大学湘雅医院老年病科老年外科 国家老年疾病临床医学研究中心(湘雅)
  • 收稿日期:2022-09-21 出版日期:2023-02-10
  • 通信作者: 彭健
  • 基金资助:
    湖南省科技厅临床医疗技术创新引导项目(2020SK5181); 湖南省卫生健康委员会临床医学研究专项课题(20201950)

Early diagnosis and screening of hepatocellular carcinoma

Chengming Ding1, Jiafeng Hou1, Guangwei Tao1   

  • Received:2022-09-21 Published:2023-02-10
引用本文:

丁成明, 侯嘉丰, 陶光伟, 齐硕, 谢翼, 冯灿, 陈振坤, 蒋心渺, 邓鑫, 彭健. 肝细胞癌早期诊断和筛查[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(01): 22-28.

Chengming Ding, Jiafeng Hou, Guangwei Tao. Early diagnosis and screening of hepatocellular carcinoma[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(01): 22-28.

原发性肝癌(肝癌)包括肝细胞癌(HCC)、肝内胆管细胞癌(ICC)和混合型3种,其中HCC占85%~90%[1]。肝癌具有较高的发病率,居全球恶性肿瘤的第6位,而中国肝癌患者约占全世界肝癌患者的50%左右,且发病率呈现不断上升趋势[2]。此外,肝癌病死率亦居高不下,其5年生存率仅为10%左右,居中国常见恶性肿瘤致死率的第2位[3]。究其原因为肝癌起病隐匿,疾病进展快,初期常很难发现,确诊时基本已发展至中晚期。实现肝癌的早期发现、精准诊断、根治性治疗,是有效提高肝癌患者5年生存率及生活质量的重要手段。本文总结和分析了近年多种HCC早期诊断方法,旨在为HCC早期诊疗提供临床依据。

[1]
Huang TE, Deng YN, Hsu JL, et al. Evaluation of the anticancer activity of a bile acid-dihydroartemisinin hybrid ursodeoxycholic-dihydroartemisinin in hepatocellular carcinoma cells[J]. Front Pharmacol, 2020(11):599067.
[2]
Fitzmaurice C, Abate D, Abbasi N, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: a systematic analysis for the global burden of disease study[J]. JAMA Oncol, 2019, 5(12):1749-1768.
[3]
郑荣寿, 孙可欣, 张思维, 等. 2015年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2019, 41(1):19-28.
[4]
Park YN, Kim MJ. Hepatocarcinogenesis: imaging-pathologic correlation[J]. Abdominal Imaging, 2011, 36(3):232-243.
[5]
Aihara T, Noguchi S, Sasaki Y, et al. Clonal analysis of regenerative nodules in hepatitis C virus-induced liver cirrhosis[J]. Gastroenterology, 1994, 107(6):1805-1811.
[6]
Park YN. Update on precursor and early lesions of hepatocellular carcinomas[J]. Arch Pathol Lab Med, 2011, 135(6):704-715.
[7]
International Consensus Group for Hepatocellular Neoplasia. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia[J]. Hepatology, 2009, 49(2):658-664.
[8]
Galle PR, Foerster F, Kudo M, et al. Biology and significance of alpha-fetoprotein in hepatocellular carcinoma[J]. Liver Int, 2019, 39(12):2214-2229.
[9]
Hsia CY, Huo TI, Chiang SY,et al. Evaluation of interleukin-6, interleukin-10 and human hepatocyte growth factor as tumor markers for hepatocellular carcinoma[J]. Eur J Surg Oncol, 2007, 33(2):208-212.
[10]
Yi X, Yu S, Bao Y. Alpha-fetoprotein-L3 in hepatocellular carcinoma: a meta-analysis[J]. Clin Chim Acta, 2013(425):212-220.
[11]
Zheng Q, Bao C, Guo W, et al. Circular RNA profiling reveals an abundant circHIPK3 that regulates cell growth by sponging multiple miRNAs[J]. Nat Commun, 2016(7):11215.
[12]
Ren S, Xin Z, Xu Y, et al. Construction and analysis of circular RNA molecular regulatory networks in liver cancer[J]. Cell Cycle, 2017, 16(22):2204-2211.
[13]
王婷, 吴文晓, 马全涛, 等. 肝癌早期诊断标志物的研究进展[J]. 中国药事, 2020, 34(3):349-356.
[14]
Xing H, Zheng YJ, Han J, et al. Protein induced by vitamin K absence or antagonist-Ⅱ versus alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: a systematic review with meta-analysis[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(6):487-495.
[15]
国家卫生健康委员会. 原发性肝癌诊疗规范(2019年版)[J]. 临床肝胆病杂志, 2020, 36(2):277-292.
[16]
Best J, Bilgi H, Heider D, et al. The GALAD scoring algorithm based on AFP, AFP-L3, and DCP significantly improves detection of BCLC early stage hepatocellular carcinoma[J]. Z Gastroenterol, 2016, 54(12):1296-1305.
[17]
Xu WJ, Guo BL, Han YG, et al. Diagnostic value of alpha-fetoprotein-L3 and Golgi protein 73 in hepatocellular carcinomas with low AFP levels[J]. Tumor Biol, 2014, 35(12):12069-12074.
[18]
刘毓键, 马明洋. 血清标志物在肝细胞肝癌早期诊断中的研究进展及应用前景[J]. 医学综述, 2020, 26(7):1325-1330, 1336.
[19]
Xu D, Su C, Sun L, et al. Performance of serum glypican 3 in diagnosis of hepatocellular carcinoma: a meta-analysis[J]. Ann Hepatol, 2019, 18(1):58-67.
[20]
Zhu M, Zheng J, Wu F, et al. OPN is a promising serological biomarker for hepatocellular carcinoma diagnosis[J]. J Med Virol, 2020, DOI: 10.1002/jmv.25704[Epub ahead of print].
[21]
Fezza M, Moussa M, Aoun R, et al. DKK1 promotes hepatocellular carcinoma inflammation, migration and invasion: implication of TGF-β1[J]. PLoS One, 2019, 14(9):e0223252.
[22]
Shen Q, Fan J, Yang XR, et al. Serum DKK1 as a protein biomarker for the diagnosis of hepatocellular carcinoma: a large-scale, multicentre study[J]. Lancet Oncol, 2012, 13(8):817-826.
[23]
Zhou JYu LGao X,et al. Plasma microRNA panel to diagnose hepatitis B virus-related hepatocellular carcinoma[J]. J Clin Oncol201129(36):4781-4788.
[24]
Peng C, Ye Y, Wang Z, et al. Circulating microRNAs for the diagnosis of hepatocellular carcinoma[J]. Dig Liver Dis, 2019, 51(5):621-631.
[25]
Peng W, Fan H. Long non-coding RNA PANDAR correlates with poor prognosis and promotes tumorigenesis in hepatocellular carcinoma[J]. Biomed Pharmacother, 2015(72):113-118.
[26]
El-Tawdi AH, Matboli M, El-Nakeep S, et al. Association of long noncoding RNA and c-JUN expression in hepatocellular carcinoma[J]. Expert Rev Gastroenterol Hepatol, 2016, 10(7):869-877.
[27]
Yuan W, Sun Y, Liu L, et al. Circulating lncRNAs serve as diagnostic markers for hepatocellular carcinoma[J]. Cell Physiol Biochem, 2017, 44(1):125-132.
[28]
Ignatiadis M, Dawson SJ. Circulating tumor cells and circulating tumor DNA for precision medicine: dream or reality?[J]. Ann Oncol, 2014, 25(12):2304-2313.
[29]
Huang AZhang XZhou SL,et al. Detecting circulating tumor DNA in hepatocellular carcinoma patients using droplet digital PCR is feasible and reflects intratumoral heterogeneity[J]. J Cancer20167(13):1907-1914.
[30]
Huang AZhao XYang XR,et al. Circumventing intratumoral heterogeneity to identify potential therapeutic targets in hepatocellular carcinoma[J]. J Hepatol201767(2):293-301.
[31]
Wen LLi JGuo H,et al. Genome-scale detection of hypermethylated CpG islands in circulating cell-free DNA of hepatocellular carcinoma patients[J]. Cell Res201525(11):1250-1264.
[32]
Xu RHWei WKrawczyk M,et al. Circulating tumour DNA methylation markers for diagnosis and prognosis of hepatocellular carcinoma[J]. Nat Mater, 2017, 16(11):1155-1161.
[33]
Cai J, Chen L, Zhang Z, et al. Genome-wide mapping of 5-hydroxymethylcytosines in circulating cell-free DNA as a non-invasive approach for early detection of hepatocellular carcinoma[J]. Gut, 2019, 68(12):2195-2205.
[34]
Sepideh A, Karim P, Hossein A, et al. Effects of multistrain probiotic supplementation on glycemic and inflammatory indices in patients with nonalcoholic fatty liver disease: a double-blind randomized clinical trial[J]. J Am Coll Nutr, 2016, 35(6):500-505.
[35]
Ren Z, Li A, Jiang J, et al. Gut microbiome analysis as a tool towards targeted non-invasive biomarkers for early hepatocellular carcinoma[J]. Gut, 2019, 68(6):1014-1023.
[36]
Palmer WC, Patel T. Are common factors involved in the pathogenesis of primary liver cancers? a meta-analysis of risk factors for intrahepatic cholangiocarcinoma[J]. J Hepatol, 2012, 57(1):69-76.
[37]
Kitao A, Matsui O, Yoneda N, et al. The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging[J]. Eur Radiol, 2011, 21(10):2056-2066.
[38]
Bota S, Piscaglia F, Marinelli S, et al. Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma[J]. Liver Cancer, 2012, 1(3/4):190-200.
[39]
European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(4):908-943.
[40]
Sangiovanni A, Manini MA, Iavarone M, et al. The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis[J]. Gut, 2010, 59(5):638-644.
[41]
Okada M, Imai Y, Kim T, et al. Comparison of enhancement patterns of histologically confirmed hepatocellular carcinoma between gadoxetate- and ferucarbotran-enhanced magnetic resonance imaging[J]. J Magn Reson Imaging, 2010, 32(4):903-913.
[42]
Lee DH, Lee JM, Baek JH, et al. Diagnostic performance of gadoxetic acid-enhanced liver MR imaging in the detection of HCCs and allocation of transplant recipients on the basis of the Milan criteria and UNOS guidelines: correlation with histopathologic findings[J]. Radiology, 2015, 274(1):149-160.
[43]
Kim YS, Song JS, Lee HK, et al. Hypovascular hypointense nodules on hepatobiliary phase without T2 hyperintensity on gadoxetic acid-enhanced MR images in patients with chronic liver disease: long-term outcomes and risk factors for hypervascular transformation[J]. Eur Radiol, 2016, 26(10):3728-3736.
[44]
Park MS, Kim S, Patel J, et al. Hepatocellular carcinoma: detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients[J]. Hepatology, 2012, 56(1):140-148.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[3] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[4] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[5] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[6] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[7] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[8] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[9] 刘敏思, 李荣, 李媚. 基于GGT与Plt比值的模型在HBV相关肝细胞癌诊断中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 831-835.
[10] 严虹霞, 王晓娟, 张毅勋. 2 型糖尿病对结直肠癌患者肿瘤标记物、临床病理及预后的影响[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 483-487.
[11] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[12] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[13] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[14] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要