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Pathology of Cholangiocarcinoma. 胆管癌的病理。
Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35166-2_5
Supinda Koonmee, Prakasit Sa-Ngiamwibool, Chaiwat Aphivatanasiri, Waritta Kunprom, Piyapharom Intarawichian, Walailak Bamrungkit, Sakkarn Sangkhamanon, Malinee Thanee

The liver excretes bile through the biliary system, which has a complicated anatomical structure. Cholangiocarcinoma, a malignant bile duct epithelial tumor, is separated into intrahepatic and extrahepatic portions depending on the structure of the bile duct and exhibits both similarities and varieties in patient presentations and staging. The three main macroscopic characteristics of cholangiocarcinoma-mass formating, intraductal growth, and periductal infiltrating types-allow pathologists and surgeons to see and analyze the cancerous tissue. The majority of cholangiocarcinoma patients are in advanced stages and poor prognosis. Although surgery is the main treatment option, target therapy based on molecular pathology background offers hope for improving patient's prognosis.

肝脏通过胆道系统排泄胆汁,胆道系统具有复杂的解剖结构。胆管癌是一种恶性胆管上皮肿瘤,根据胆管的结构分为肝内和肝外两部分,在患者表现和分期上既有相似之处,也有不同之处。胆管癌的三个主要宏观特征——肿块形成、导管内生长和导管周围浸润类型——使病理学家和外科医生能够观察和分析癌组织。胆管癌患者多为晚期,预后较差。虽然手术是主要的治疗选择,但基于分子病理学背景的靶向治疗为改善患者预后提供了希望。
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引用次数: 0
Digital Innovations (Isan Cohort). 数字创新(Isan Cohort)。
Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35166-2_10
Bandit Thinkhamrop, Kavin Thinkhamrop, Chaiwat Tawarungrueng, Panuwat Prathumkham

Innovations in digital procedures are discussed and highlighted in this chapter providing a comprehensive background and an overview of the Cholangiocarcinoma Screening and Care Program (CASCAP), and the innovative data base known as the Isan cohort, including the O. viverrini - CCA module, tele-radiology, databases for pathology, surgery, palliative care, and a randomized controlled trial database.

本章讨论并强调了数字程序的创新,提供了全面的背景和胆管癌筛查和护理计划(CASCAP)的概述,以及称为Isan队列的创新数据库,包括O. viverrini - CCA模块,远程放射学,病理,外科,姑息治疗数据库和随机对照试验数据库。
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引用次数: 0
Synopsis. 剧情简介。
Q3 Medicine Pub Date : 2023-01-01 DOI: 10.1007/978-3-031-35166-2_13
Narong Khuntikeo, Ross H Andrews, Trevor N Petney, Shahid A Khan

Cholangiocarcinoma (CCA) is the second most common primary liver cancer worldwide. Despite the severity of the disease and its impact on individuals, families, and communities, there remains an overall lack of awareness and interest in this disease. The information contained in the chapters of this book shows that this is indeed a significant public health and socioeconomic problem with varying levels of country-specific awareness. In Southeast Asia liver fluke, O. viverrini related CCA is endemic with the highest incidence worldwide in northeast Thailand, yet it is treatable and preventable. The chapters highlight significant advances in our knowledge of the biology and epidemiology of the O. viverrini species complex, intermediate hosts, systematics, population genetics, and the complexity of the three-host life cycle. A comprehensive conceptual framework has been developed to assist in understanding the complexity of molecular mechanisms of CCA carcinogenesis and cancer development which can result in improvement of targeted CCA therapy. There have been many advances in understanding the pathology of CCA in the biliary tract, including advances in prognosis and molecular pathogenesis. The development of different modalities and their advantages for diagnosis have increased diagnostic accuracy, providing reliable information allowing appropriate treatment and management programs to be selected for each patient. Particularly exciting is the recent development of a urine antigen assay which has revolutionized the diagnostic approach of opisthorchiasis due to its simplicity, the non-invasive nature of sample collection, and its ease of use in field settings. Significant in-roads and advances have been made in the surgical and systemic treatment of CCA patients. Additionally, a sophisticated data collection and analysis system, the Isan Cohort, has been developed and established for the treatment and control of CCA. Importantly, a greater understanding has been made of the social, community, religious, and anthropological issues initiating and sustaining the eating behavior of raw, partially cooked, and/or fermented fresh water fish. Specially designed education programs/curricula, based on currently available multidisciplinary hard data targeting school children, have been introduced since the inception of the Cholangiocarcinoma Screening and Care Program (CASCAP) and the subsequent strategic Fluke Free Thailand Model. The education program is being expanded to other provinces in Thailand and in the near future to other Southeast Asian countries, initially to Lao PDR, where the Fluke Free Lao PDR program has already been implemented. Despite advances that have been made in many disciplines focused on O. viverrini related CCA, raising awareness of CCA at all levels, particularly across endemic regions, is still needed, as is raising the awareness of CCA globally. As parasites and parasite related diseases have no borders, it is critical that

胆管癌(CCA)是世界上第二常见的原发性肝癌。尽管该病的严重性及其对个人、家庭和社区的影响,但总体上仍缺乏对该病的认识和兴趣。本书各章所载的资料表明,这确实是一个重大的公共卫生和社会经济问题,各国的认识程度各不相同。在东南亚,与肝吸虫相关的CCA是一种地方性疾病,在泰国东北部发病率最高,但它是可以治疗和预防的。这些章节强调了我们对O. viverrini物种复杂,中间宿主,系统学,群体遗传学和三宿主生命周期复杂性的生物学和流行病学知识的重大进展。一个全面的概念框架已经发展起来,以帮助理解CCA致癌和癌症发展的分子机制的复杂性,这可以导致靶向CCA治疗的改进。在对胆道CCA的病理认识方面有许多进展,包括预后和分子发病机制方面的进展。不同模式的发展及其诊断的优势提高了诊断的准确性,提供了可靠的信息,允许为每个患者选择适当的治疗和管理方案。尤其令人兴奋的是最近开发的尿液抗原测定法,由于其简单、样品采集的非侵入性以及在现场环境中易于使用,彻底改变了opisthorchiasis的诊断方法。在CCA患者的手术和全身治疗方面取得了重大进展和进展。此外,已经开发并建立了一个复杂的数据收集和分析系统,即Isan队列,用于治疗和控制CCA。重要的是,人们对社会、社区、宗教和人类学问题有了更深入的了解,这些问题引发并维持了生吃、部分煮熟和/或发酵淡水鱼的行为。自胆管癌筛查和护理项目(CASCAP)和随后的泰国无吸虫战略模式启动以来,根据目前可获得的针对学龄儿童的多学科硬数据,引入了专门设计的教育项目/课程。该教育项目正在泰国其他省份推广,并在不久的将来推广到其他东南亚国家,首先是老挝人民民主共和国,在那里已经实施了“消灭福禄克”老挝人民民主共和国项目。尽管在聚焦于与毒舌虫相关的CCA的许多学科中取得了进展,但仍然需要在各级,特别是在流行地区提高对CCA的认识,同时也需要在全球范围内提高对CCA的认识。由于寄生虫和与寄生虫有关的疾病没有国界,因此至关重要的是,在与肝吸虫、弧菌有关的CCA是一个重大公共卫生问题的所有国家之间发起和制定一项有效的共同战略计划,从而提高数百万患有这种潜伏疾病的人的生活质量和预期寿命。
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引用次数: 0
Novel Functions and Virus-Host Interactions Implicated in Pathogenesis and Replication of Human Herpesvirus 8. 与人类疱疹病毒发病和复制有关的新功能和病毒-宿主相互作用
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-57362-1_11
Young Bong Choi, Emily Cousins, John Nicholas

Human herpesvirus 8 (HHV-8) is classified as a γ2-herpesvirus and is related to Epstein-Barr virus (EBV), a γ1-herpesvirus. One important aspect of the γ-herpesviruses is their association with neoplasia, either naturally or in animal model systems. HHV-8 is associated with B-cell-derived primary effusion lymphoma (PEL) and multicentric Castleman's disease (MCD), endothelial-derived Kaposi's sarcoma (KS), and KSHV inflammatory cytokine syndrome (KICS). EBV is also associated with a number of B-cell malignancies, such as Burkitt's lymphoma, Hodgkin's lymphoma, and posttransplant lymphoproliferative disease, in addition to epithelial nasopharyngeal and gastric carcinomas. Despite the similarities between these viruses and their associated malignancies, the particular protein functions and activities involved in key aspects of virus biology and neoplastic transformation appear to be quite distinct. Indeed, HHV-8 specifies a number of proteins for which counterparts had not previously been identified in EBV, other herpesviruses, or even viruses in general, and these proteins are believed to play vital functions in virus biology and to be involved centrally in viral pathogenesis. Additionally, a set of microRNAs encoded by HHV-8 appears to modulate the expression of multiple host proteins to provide conditions conductive to virus persistence within the host and possibly contributing to HHV-8-induced neoplasia. Here, we review the molecular biology underlying these novel virus-host interactions and their potential roles in both virus biology and virus-associated disease.

人疱疹病毒8 (HHV-8)被归类为γ - 2疱疹病毒,与γ - 1疱疹病毒eb病毒(EBV)有亲缘关系。γ-疱疹病毒的一个重要方面是它们与肿瘤的关联,无论是自然的还是在动物模型系统中。HHV-8与b细胞源性原发性积液淋巴瘤(PEL)和多中心Castleman病(MCD)、内皮源性卡波西肉瘤(KS)和KSHV炎性细胞因子综合征(KICS)相关。EBV还与许多b细胞恶性肿瘤相关,如伯基特淋巴瘤、霍奇金淋巴瘤和移植后淋巴细胞增生性疾病,以及上皮性鼻咽癌和胃癌。尽管这些病毒及其相关的恶性肿瘤有相似之处,但涉及病毒生物学和肿瘤转化关键方面的特定蛋白质功能和活动似乎非常不同。事实上,HHV-8指定了许多蛋白质,这些蛋白质以前在EBV、其他疱疹病毒甚至一般病毒中没有被发现,这些蛋白质被认为在病毒生物学中起着至关重要的作用,并在病毒发病过程中起着核心作用。此外,一组由HHV-8编码的microrna似乎可以调节多种宿主蛋白的表达,从而为病毒在宿主内的持续存在提供条件,并可能导致HHV-8诱导的肿瘤形成。在这里,我们回顾了这些新型病毒-宿主相互作用的分子生物学基础及其在病毒生物学和病毒相关疾病中的潜在作用。
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引用次数: 2
Chapter XX Antiviral Treatment and Cancer Control. 第二十章抗病毒治疗与肿瘤控制。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-57362-1_13
Wei-Liang Shih, Chi-Tai Fang, Pei-Jer Chen

Hepatitis B virus (HBV), hepatitis C virus (HCV), human papilloma virus (HPV), Epstein-Barr virus (EBV), human T-cell lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and Merkel cell polyomavirus (MCV) contribute to about 10-15% global burden of human cancers. Conventional chemotherapy or molecular target therapies have been used to treat virus-associated cancers. However, a more proactive approach would be the use of antiviral treatment to suppress or eliminate viral infections to prevent the occurrence of cancer in the first place. Antiviral treatments against chronic HBV and HCV infection have achieved this goal, with significant reduction in the incidence of hepatocellular carcinoma in treated patients. Antiviral treatments for EBV, KSHV, and HTLV-1 had limited success in treating refractory EBV-associated lymphoma and post-transplant lymphoproliferative disorder, KSHV-associated Kaposi's sarcoma in AIDS patients, and HTLV-1-associated acute, chronic, and smoldering subtypes of adult T-cell lymphoma, respectively. Therapeutic HPV vaccine and RNA interference-based therapies for treating HPV-associated infection or cervical cancers also showed some encouraging results. Taken together, antiviral therapies have yielded promising results in cancer prevention and treatment. More large-scale studies in a real-world setting are necessary to confirm the efficacy of antiviral therapy. Further investigation for more effective and convenient antiviral regimens warrants more attention.

乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人乳头瘤病毒(HPV)、爱泼斯坦-巴尔病毒(EBV)、人t细胞嗜淋巴病毒1型(HTLV-1)、卡波西肉瘤相关疱疹病毒(KSHV)和默克尔细胞多瘤病毒(MCV)造成了全球约10-15%的人类癌症负担。传统的化学疗法或分子靶向疗法已被用于治疗病毒相关的癌症。然而,一种更积极的方法是使用抗病毒治疗来抑制或消除病毒感染,从一开始就预防癌症的发生。针对慢性HBV和HCV感染的抗病毒治疗已经实现了这一目标,治疗患者的肝细胞癌发病率显著降低。EBV、KSHV和HTLV-1的抗病毒治疗分别在治疗难治性EBV相关淋巴瘤和移植后淋巴细胞增生性疾病、艾滋病患者的KSHV相关卡波西肉瘤和HTLV-1相关的急性、慢性和阴烧亚型成人t细胞淋巴瘤方面取得了有限的成功。用于治疗HPV相关感染或宫颈癌的治疗性HPV疫苗和基于RNA干扰的疗法也显示出一些令人鼓舞的结果。总的来说,抗病毒疗法在癌症预防和治疗方面取得了令人鼓舞的成果。为了证实抗病毒治疗的有效性,需要在现实环境中进行更多的大规模研究。进一步研究更有效和方便的抗病毒方案值得更多的关注。
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引用次数: 0
Experiencing Cancer. An Ethnographic Study on Illness and Disease. 经历过癌症。疾病与疾病的民族志研究。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-63749-1_16
Christine Holmberg

Cancer is seen as a 'dread disease' with a long and powerful history that remains resistant to defeat. It is a byword for suffering, pain and death. An unprecedented level of research spending and biomedical engagement offering new treatment options and hopes for a cure goes hand in hand with patient-led movements disseminating widespread public narratives of hope and survivorship. A key paradigm in these public narratives of hope and cure has been early detection of disease, with breast cancer, as the most frequent cancer among women, at the forefront of early detection campaigns. This chapter investigates the experiences behind the public face of breast cancer. It interrogates what it means to have breast cancer in the light of heroic stories of survivorship and fight using the theoretical concepts of illness-the subjective experience of feeling unwell-and disease-bodily pathologies that are identified through biomedical diagnostic technologies. With early detection becoming the primary mode of practice in breast cancer, illness has  to be re-conceptualized. If a woman is to undergo treatment after a diagnosis of asymptomatic disease-without symptoms being present in her lifeworld-she has to cognitively understand the severity of the disease, and assume that she would die without treatment. The absence of bodily experiences of symptoms is irrelevant: it is the provision of information through which illness can manifest. The shock of diagnosis, as so often illustrated in cancer narratives, is therefore necessary in order to transform disease into an illness trajectory associated with biomedical treatment. The particular illness experiencehas profound and long-lasting consequences for a woman's life. Understanding the suffering associated with such disease conceptions as a necessary part of the illness experience could help us to improve health care services for those afflicted.

癌症被视为一种“可怕的疾病”,有着悠久而强大的历史,仍然难以战胜。它是苦难、痛苦和死亡的代名词。前所未有的研究支出和生物医学参与提供了新的治疗选择和治愈的希望,与患者主导的运动携手并进,广泛传播希望和幸存者的公众叙事。在这些关于希望和治愈的公共叙述中,一个关键范例是早期发现疾病,乳腺癌作为妇女中最常见的癌症,处于早期发现运动的前沿。这一章调查了乳腺癌公众形象背后的经历。它通过幸存者的英雄故事和疾病的理论概念——通过生物医学诊断技术识别的身体不适和疾病的主观体验——来询问患有乳腺癌意味着什么。随着早期检测成为乳腺癌的主要实践模式,疾病必须重新概念化。如果一名妇女在被诊断为无症状疾病后接受治疗——在她的生活中没有任何症状——她必须从认知上理解疾病的严重性,并假设她不治疗就会死亡。没有症状的身体体验是无关紧要的:它提供了疾病可以表现出来的信息。因此,诊断的震惊,正如癌症叙事中经常描述的那样,对于将疾病转化为与生物医学治疗相关的疾病轨迹是必要的。这种特殊的疾病经历会对女性的生活产生深远而持久的影响。将与此类疾病概念相关的痛苦理解为疾病经历的必要组成部分,可以帮助我们改善对患者的保健服务。
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引用次数: 1
'The King of Diseases': An Essay on the Special Attention Paid to Cancer Patients and How It Came About. “疾病之王”:对癌症患者的特别关注及其由来的随笔。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-63749-1_1
Wolfgang U Eckart

The history of cancer during the twentieth century demonstrates that various factors have contributed to the perception of cancer as the 'Emperor of All Maladies', although this has never been true from an epidemiological perspective. Depending on the geographical area, infectious diseases such as tuberculosis, malaria or cardiovascular disease still head the list of the most common illnesses. Within the group of chronic-degenerative diseases, however, cancer has outdistanced the widespread classic infectious diseases as a result of the epidemiologic transition around 1900, at least in the more developed countries. Under the Nazi dictatorship from 1933 to 1945, the perception of cancer in Germany was particularly promoted for propaganda purposes. In the atomic era, cancer began to attract strong public interest as a worthwhile object of research in radiation therapies using large-scale facilities (electron accelerators, 'electron guns'). A further upsurge of interest in cancer was then registered in the context of the debate about the pathogenic role of environmental factors. The remarkable thing is that this increased perception of cancer has not yet been significantly associated with any overarching success in cancer treatment, but it has been associated with ideologies, hopes and advances in technology.

20世纪癌症的历史表明,各种因素导致人们认为癌症是“万病之王”,尽管从流行病学的角度来看,这从来都不是真的。根据地理区域的不同,结核病、疟疾或心血管疾病等传染病仍然是最常见的疾病。然而,在慢性退行性疾病组中,至少在较发达国家,由于1900年左右的流行病学转变,癌症已经超过了广泛存在的经典传染病。在1933年至1945年的纳粹独裁统治下,德国人对癌症的认识被特别宣传,以达到宣传目的。在原子时代,癌症开始引起公众的强烈兴趣,因为它是使用大型设备(电子加速器,“电子枪”)进行放射治疗的一个有价值的研究对象。在关于环境因素致病作用的辩论中,人们对癌症的兴趣进一步高涨。值得注意的是,这种对癌症的认识的增加还没有明显地与癌症治疗的任何总体成功联系起来,但它与意识形态、希望和技术进步有关。
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引用次数: 0
Cancer, the Media and Dealing with Knowledge. 巨蟹座、媒体和知识处理。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-63749-1_8
Florian Steger, Maximilian Schochow

Among the primary function of the media are conveying personal understanding and expanding the subjective knowledge of the recipient citizen. A particular challenge arising during this process is the mediation of medical knowledge. In addition to pure factual knowledge, it often involves subjective experiences, hopes and wishes. One example of this is media reports about cancer therapies. As a result of widespread media coverage since 2017, the public is under the impression that methadone is a promising treatment for cancer. This chapter analyzes the part played by the media and the ethical debate. The ethical issues that arise concern good scientific practice, patient autonomy and the media coverage of methadone. We conclude that, according to the current state of research, the promotion of methadone as a cure for cancer is ethically unacceptable. In this case the media are not fulfilling their task of imparting knowledge, because they are not communicating the current state of research or the associated ethical questions.

媒介的主要功能是传达个人的理解和扩大受众的主观认识。在这一过程中出现的一个特殊挑战是医学知识的调解。除了纯粹的事实知识外,它还经常涉及主观经验、希望和愿望。其中一个例子就是媒体对癌症治疗的报道。由于2017年以来媒体的广泛报道,公众的印象是美沙酮是一种很有希望的癌症治疗方法。本章分析了媒体和伦理辩论所起的作用。由此产生的伦理问题涉及良好的科学实践、患者自主权和媒体对美沙酮的报道。我们的结论是,根据目前的研究状况,推广美沙酮治疗癌症在伦理上是不可接受的。在这种情况下,媒体没有履行其传授知识的任务,因为它们没有传达研究的现状或相关的伦理问题。
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引用次数: 0
Routine Oncology Treatment and Its Human Deficits. 常规肿瘤治疗及其人类缺陷。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-63749-1_15
Ralf-Dieter Hofheinz

Working with cancer patients is a highly demanding task. Both, caring for physical, social and spiritual needs of cancer patients as well as an overwhelming bureaucratisation, and technologisation challenge oncologists in a way that may cause mental and physical exhaustion, often-paradoxically-despite high job and specialty satisfaction. This article (i) summarises research findings with a special focus on oncologists' burnout (including factors associated with the phenomffenon), job satisfaction and physical health; (ii) describes potential consequences of burnout and distress, e.g., shortcomings in the physician-patient interaction in oncological treatment settings, financial implications on the health-care system, etc.; and (iii) reviews published data for interventions that may prevent or alleviate oncologists' burnout on an organisational and/or individual level.

与癌症患者一起工作是一项要求很高的任务。照顾癌症患者的身体、社会和精神需求,以及压倒性的官僚化和技术化,这两者都给肿瘤学家带来了挑战,可能会导致精神和身体上的疲惫,尽管他们的工作和专业满意度很高,但往往是矛盾的。本文(i)总结了研究结果,特别关注肿瘤学家的职业倦怠(包括与该现象相关的因素)、工作满意度和身体健康;(ii)描述倦怠和痛苦的潜在后果,例如,肿瘤治疗环境中医患互动的缺陷,对卫生保健系统的财务影响等;(iii)回顾已发表的干预数据,以预防或减轻肿瘤医生在组织和/或个人层面上的职业倦怠。
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引用次数: 0
Prevention of Hepatitis B Virus Infection and Liver Cancer. 预防乙型肝炎病毒感染和肝癌。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-57362-1_4
Mei-Hwei Chang

Hepatocellular carcinoma (HCC) is one of the five leading causes of cancer death in human. Hepatitis B virus (HBV) is the most common etiologic agent of HCC in the world. Prevention is the best way to control cancer. There are three levels of liver cancer prevention, i.e., primary prevention by HBV vaccination targeting the general population starting from birth dose, secondary prevention by antiviral agent for high-risk subjects with chronic HBV infection, and tertiary prevention by antiviral agent to prevent recurrence for patients who have been successfully treated for liver cancer. Primary prevention by hepatitis B vaccination is most cost effective, the cancer preventive efficacy support it as the first successful example of cancer preventive vaccine in human. Addition of hepatitis B immunoglobulin immediately after birth and antiviral agent during the third trimester of pregnancy to block mother-to-infant transmission of HBV are existing or possible emerging strategies to enhance the prevention efficacy of HBV infection and its related liver cancer. Secondary prevention with current antiviral agents may reduce the risk or delay the onset of HCC development, but could not eradicate HBV infection and HCC. Better antiviral therapeutic agents are needed for better secondary prevention.

肝细胞癌(HCC)是人类癌症死亡的五大主要原因之一。乙型肝炎病毒(HBV)是世界上最常见的HCC病因。预防是控制癌症的最好方法。肝癌的预防有三个层次,即从出生剂量开始针对一般人群接种HBV疫苗的一级预防,对慢性HBV感染高危人群使用抗病毒药物的二级预防,以及对肝癌治疗成功的患者使用抗病毒药物预防复发的三级预防。通过乙肝疫苗进行一级预防是最具成本效益的,其癌症预防效果支持它作为人类癌症预防疫苗的第一个成功例子。出生后立即加用乙肝免疫球蛋白和妊娠晚期加用抗病毒药物阻断HBV母婴传播是现有或可能出现的提高HBV感染及其相关肝癌预防效果的策略。目前抗病毒药物的二级预防可以降低HCC的发病风险或延缓HCC的发生,但不能根除HBV感染和HCC。需要更好的抗病毒治疗药物来实现更好的二级预防。
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引用次数: 3
期刊
Recent Results in Cancer Research
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