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Liver cancer screening in high-risk populations. 高危人群的肝癌筛查
IF 5 Pub Date : 2016-01-01 Epub Date: 2015-11-30 DOI: 10.2217/hep.15.35
Morris Sherman

Patients with liver disease have a risk of developing hepatocellular carcinoma (HCC), but the risk varies between different diseases and is also different according to several other variables, such as age, type of underlying liver disease and severity of disease. Several risk scores have been developed to more adequately quantitate HCC risk in individual patients. Each risk score is applicable to a specific population (chronic hepatitis B or C, patients on the transplant list, cirrhosis in general, and so on). Most publications on risk scores do not provide clear guidance as to what level of measured risk is sufficient to trigger surveillance.

肝脏疾病患者有发生肝细胞癌(HCC)的风险,但不同疾病之间的风险不同,并且根据其他几个变量(如年龄、潜在肝脏疾病类型和疾病严重程度)也有所不同。一些风险评分已经被开发出来,以更充分地量化个体患者的HCC风险。每个风险评分适用于特定人群(慢性乙型或丙型肝炎,移植名单上的患者,一般的肝硬化,等等)。大多数关于风险评分的出版物都没有提供明确的指导,说明测量的风险达到何种程度才足以引发监测。
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引用次数: 1
Role of alcohol in the development and progression of hepatocellular carcinoma. 酒精在肝细胞癌发生发展中的作用。
IF 5 Pub Date : 2016-01-01 Epub Date: 2015-11-30 DOI: 10.2217/hep.15.40
Iain H McKillop, Laura W Schrum, Kyle J Thompson

Hepatocellular carcinoma (HCC) is a significant cause of cancer-related morbidity and mortality. Chronic, heavy ethanol consumption is a major risk for developing the worsening liver pathologies that culminate in hepatic cirrhosis, the leading risk factor for developing HCC. A significant body of work reports the biochemical and pathological consequences of ethanol consumption and metabolism during hepatocarcinogeneis. The systemic effects of ethanol means organ system interactions are equally important in understanding the initiation and progression of HCC within the alcoholic liver. This review aims to summarize the effects of ethanol-ethanol metabolism during the pathogenesis of alcoholic liver disease, the progression toward HCC and the importance of ethanol as a comorbid factor for HCC development.

肝细胞癌(HCC)是导致癌症相关发病率和死亡率的重要原因。长期大量饮酒是导致肝脏病变恶化的主要风险,最终导致肝硬化,肝硬化是发展为HCC的主要风险因素。大量研究报告了肝癌发生过程中乙醇消耗和代谢的生化和病理后果。乙醇的全身效应意味着器官系统的相互作用对于理解酒精性肝内HCC的发生和发展同样重要。这篇综述旨在总结乙醇-乙醇代谢在酒精性肝病发病机制中的作用、向HCC的进展以及乙醇作为HCC发展的共病因素的重要性。
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引用次数: 15
Neoadjuvant treatment of biliary tract cancer: state-of-the-art and new perspectives. 胆道癌的新辅助治疗:最新的和新的观点。
IF 5 Pub Date : 2016-01-01 Epub Date: 2015-11-30 DOI: 10.2217/hep.15.43
Marco Imperatori, Loretta D'Onofrio, Eleonora Marrucci, Francesco Pantano, Alice Zoccoli, Giuseppe Tonini

Gall bladder cancer (GBC), and intrahepatic and extrahepatic (perihilar or distal bile duct's) cholangiocarcinomas (CCA) are usually diagnosed in locally advanced or node-positive stage, with a short survival rate. Thus, it appears essential to explore novel strategies for improving disease downstage and radical surgery. Chemoradiotherapy followed by liver transplantation seems to be one of the most promising approaches for intrahepatic or perihilar disease while chemotherapy with novel radiotherapy techniques (such stereotactic body radiation) emerged as an attractive preoperative treatment in distal diseases. In this paper, we will review currently available knowledge about neoadjuvant treatment of biliary tract cancers (BTC) paying attention to challenges that make this type of management in clinical practice difficult.

胆囊癌(GBC)和肝内、肝外(肝门周围或远端胆管)胆管癌(CCA)通常诊断为局部晚期或淋巴结阳性,生存率较短。因此,探索改善晚期疾病和根治性手术的新策略显得至关重要。放化疗后肝移植似乎是肝内或肝门周围疾病最有前途的方法之一,而化疗结合新型放疗技术(如立体定向体辐射)成为远端疾病的一种有吸引力的术前治疗方法。在本文中,我们将回顾目前关于胆道肿瘤(BTC)新辅助治疗的现有知识,并关注使这种管理在临床实践中困难的挑战。
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引用次数: 10
Targeting glucose metabolism in cancer: new class of agents for loco-regional and systemic therapy of liver cancer and beyond? 靶向糖代谢治疗癌症:肝癌局部、局部和全身治疗的新药物?
IF 5 Pub Date : 2016-01-01 DOI: 10.2217/HEP.15.36
L. Savic, J. Chapiro, G. Duwe, J. Geschwind
Hepatocellular carcinoma (HCC) is one of the most prevalent cancers and the third leading cause of cancer-related deaths worldwide. In patients with unresectable disease, loco-regional catheter-based intra-arterial therapies (IAT) can achieve selective tumor control while minimizing systemic toxicity. As molecular features of tumor growth and microenvironment are better understood, new targets arise for selective anticancer therapy. Particularly, antiglycolytic drugs that exploit the hyperglycolytic cancer cell metabolism - also known as the 'Warburg effect' - have emerged as promising therapeutic options. Thus, future developments will combine the selective character of loco-regional drug delivery platforms with highly specific molecular targeted antiglycolytic agents. This review will exemplify literature on antiglycolytic approaches and particularly focus on intra-arterial delivery methods.
肝细胞癌(HCC)是最常见的癌症之一,也是全球癌症相关死亡的第三大原因。对于无法切除的疾病患者,局部区域导管动脉内治疗(IAT)可以实现选择性肿瘤控制,同时最小化全身毒性。随着对肿瘤生长和微环境的分子特征的进一步了解,选择性抗癌治疗出现了新的靶点。特别是,利用高糖酵解癌细胞代谢的抗糖酵解药物——也被称为“Warburg效应”——已经成为有希望的治疗选择。因此,未来的发展将结合局部区域药物递送平台的选择性和高度特异性的分子靶向抗糖酵解药物。本综述将列举有关抗糖酵解方法的文献,并特别关注动脉内给药方法。
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引用次数: 21
Progression of systemic chemotherapy with oxaliplatin-containing regimens for advanced hepatocellular carcinoma in China. 含奥沙利铂方案治疗中国晚期肝细胞癌的全身化疗进展
IF 5 Pub Date : 2016-01-01 Epub Date: 2015-11-30 DOI: 10.2217/hep.15.42
Shukui Qin, Xinlei Gong

Hepatocellular carcinoma (HCC) characterized by insidious onset is a highly invasive malignance and has a rapid progress. The majority of patients, especially in Asian countries, present with locally advanced or distant metastatic disease at diagnosis and are not eligible for local treatment. Before the publication of the EACH study results showing the survival benefits of the FOLFOX 4 regimen in Chinese patients with advanced HCC, no chemotherapeutical drug or regimen was considered as systemic chemotherapy standard for this group of patients due to the lack of evidence-based recommendations. Oxaliplatin-containing regimens have shown clinical activity against advanced HCC with an acceptable safety profile. The aim of this article is to present a review of the scientific evidence mainly originating from China that supports the recommendation of oxaliplatin-based regimens for the treatment of Chinese patients with advanced HCC.

肝细胞癌(HCC)是一种发病隐匿、进展迅速的恶性肿瘤。大多数患者,特别是在亚洲国家,在诊断时表现为局部晚期或远处转移性疾病,不适合当地治疗。在EACH研究结果显示FOLFOX 4方案对中国晚期HCC患者的生存获益之前,由于缺乏循证推荐,没有化疗药物或方案被认为是该组患者的全身化疗标准。含有奥沙利铂的方案已经显示出治疗晚期HCC的临床活性,并且具有可接受的安全性。本文的目的是回顾主要来自中国的科学证据,这些证据支持奥沙利铂为基础的方案治疗中国晚期HCC患者。
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引用次数: 3
Selected summary for the 2015 Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE). 2015年亚太地区原发性肝癌专家会议(APPLE)精选摘要。
IF 5 Pub Date : 2016-01-01 Epub Date: 2015-11-30 DOI: 10.2217/hep.15.37
Augusto Villanueva

Liver cancer is now ranked second in terms of cancer-related mortality worldwide; with limited treatment options for patients at advanced stages it remains a growing health problem. All Phase III clinical trials testing molecular therapies after sorafenib have so far failed, and there is still not a validated oncogene addiction loop. Despite the present huge challenges, advancements in the recent years have been remarkable. The Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE) was designed to promote scientific exchanges of international and regional experts in the study and management of liver cancer. Over the years it has consolidated as a major resource to provide a thorough update to clinicians and researchers located in the Asia-Pacific region in different aspects of liver cancer. Attendance at these meetings is exceptional, with an average of 1000 attendees at each conference. As predicted, the 2015 edition provided an outstanding overview of the latest developments in the clinical management and molecular pathogenesis of the disease.

肝癌目前在全球癌症相关死亡率中排名第二;由于晚期患者的治疗选择有限,这仍然是一个日益严重的健康问题。迄今为止,在索拉非尼之后测试分子疗法的所有III期临床试验都失败了,并且仍然没有一个验证的癌基因成瘾循环。尽管目前面临着巨大的挑战,但近年来取得了显著的进展。亚太原发性肝癌专家会议(APPLE)旨在促进国际和地区专家在肝癌研究和管理方面的科学交流。多年来,它已巩固为亚太地区的临床医生和研究人员提供肝癌不同方面的全面更新的主要资源。参加这些会议的人数非常多,每次会议平均有1000人参加。正如预测的那样,2015年版提供了对该疾病的临床管理和分子发病机制的最新发展的杰出概述。
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引用次数: 0
Mechanisms of doxorubicin resistance in hepatocellular carcinoma. 肝细胞癌中阿霉素耐药的机制。
IF 5 Pub Date : 2016-01-01 DOI: 10.2217/HEP.15.41
Josiah Cox, S. Weinman
Hepatocellular carcinoma, one of the most common solid tumors worldwide, is poorly responsive to available chemotherapeutic approaches. While systemic chemotherapy is of limited benefit, intra-arterial delivery of doxorubicin to the tumor frequently produces tumor shrinkage. Its utility is limited, in part, by the frequent emergence of doxorubicin resistance. The mechanisms of this resistance include increased expression of multidrug resistance efflux pumps, alterations of the drug target, topoisomerase, and modulation of programmed cell death pathways. Many of these effects result from changes in miRNA expression and are particularly prominent in tumor cells with a stem cell phenotype. This review will summarize the current knowledge on the mechanisms of doxorubicin resistance of hepatocellular carcinoma and the potential for approaches toward therapeutic chemosensitization.
肝细胞癌是世界上最常见的实体肿瘤之一,对现有的化疗方法反应较差。虽然全身化疗的益处有限,但动脉内给药多柔比星往往能使肿瘤缩小。它的效用有限,部分原因是阿霉素耐药性的频繁出现。这种耐药的机制包括多药耐药外排泵的表达增加、药物靶点、拓扑异构酶的改变和程序性细胞死亡途径的调节。许多这些影响是由miRNA表达的变化引起的,在具有干细胞表型的肿瘤细胞中尤为突出。本文将对肝细胞癌的阿霉素耐药机制和化疗增敏的潜在途径进行综述。
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引用次数: 116
Intermediate hepatocellular carcinoma: the role of transarterial therapy. 中间肝癌:经动脉治疗的作用。
IF 5 Pub Date : 2015-11-06 DOI: 10.2217/HEP.15.32
F. Chegai, A. Orlacchio, S. Merolla, S. Monti, L. Mannelli
According to Barcelona Clinic Liver Cancer, the recommended first-line treatment for patients with intermediate stage of hepatocellular carcinoma (HCC) is transarterial chemoembolization. Patients with intermediate stage of HCC represent 20% with a 2-year survival of approximately 50%. Nowadays, transarterial therapies have proved precious in the treatment of hepatic malignancies. During the last years, there were important developments in practiced transarterial therapies and their efficacy is still controversial. The purpose of this review is to discuss in further details these transarterial therapies that have been used to treat cases of HCC.
根据巴塞罗那临床肝癌,中期肝细胞癌(HCC)患者推荐的一线治疗是经动脉化疗栓塞。HCC中期患者占20%,2年生存率约为50%。目前,经动脉治疗在肝脏恶性肿瘤的治疗中已被证明是宝贵的。在过去的几年里,经动脉治疗的实践有了重要的发展,但其疗效仍然存在争议。本综述的目的是进一步详细讨论这些经动脉治疗HCC的方法。
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引用次数: 12
Role of ablation: should it be used as primary therapy for early-stage hepatocellular carcinoma? 消融术的作用:是否应作为早期肝癌的主要治疗方法?
IF 5 Pub Date : 2015-10-01 Epub Date: 2015-11-06 DOI: 10.2217/hep.15.21
Maurizio Pompili, Giampiero Francica
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引用次数: 0
DNA methylation in hepatocellular carcinoma: what is the use? DNA甲基化在肝癌中的作用是什么?
IF 5 Pub Date : 2015-10-01 Epub Date: 2015-11-06 DOI: 10.2217/hep.15.22
Jeroen Dekervel, Jos van Pelt, Chris Verslype
Department of Hepatology, University Hospitals Leuven & Department of Clinical & Experimental Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium *Author for correspondence: jeroen.dekervel@med.kuleuven.be Epigenetics are heritable changes in gene expression that occur without changes in DNA sequence [1]. In this editorial we will focus on DNA methylation, the most studied form of epigenetic regulation in cancers of the liver. DNA methylation usually takes place at 5 position of the cytosine ring (resulting in 5mC) within CpG dinucleotides. These dinucleotides are relatively rare and unequally distributed throughout the genome. For example, 60% of human genes have a cluster of CpGs or so called ‘CpG island (CGI)’ in their regulatory region [2]. Methylation of a CGI results in transcriptional silencing of the associated gene. Other genomic regions with high CpG density include repetitive genomic sequences such as centromeres where DNA methylation guards chromosome stability. In a differentiated human cell, CpG islands are mostly unmethylated facilitating expression of the associated gene, whereas the baseline methylation of repetitive sequences prevents mitotic recombinations such as deletions or translocations [3]. DNA methylation, a process catalyzed by DNA methyltransferases, occurs nearly always symmetrical in both the top and bottom strands [4]. This enables propagation of methylation across cell divisions conform the heritable nature of epigenetics as stated in the definition. More recently, it has become clear that DNA undergoes active demethylation as well, regulated by the ten-eleven translocation (TET) family of proteins. These enzymes produce an intermediate, 5-hydroxymethylcytosine or 5hmC, which ultimately leads to unmethylated cytosine [5].
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引用次数: 1
期刊
Hepatic Oncology
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