Aimun Raees, Muhammad Kamran, Hasan Özkan, Wasim Jafri
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We aim to review the recent advancements in the diagnostic and therapeutic strategies for HCC.</p><p><strong>Methodology: </strong>The literature search was done using databases PubMed, Cochrane, and Science Direct, and the latest relevant articles were reviewed.</p><p><strong>Findings: </strong>Screening of HCC is a pivotal step in the early diagnosis of the disease. Current guidelines recommend using ultrasound and alfa fetoprotein but various new biomarkers are under active research that might aid in diagnosing very small tumors, not picked up by the current screening methods. Treatment options are decided based upon the overall performance of the patient and the extent of the disease, as per the Barcelona classification. There are very few options that offer a cure for the disease, ranging from liver resection and transplantation to tumor ablation. Downstaging has proven to have a significant role in the course of the disease. 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引用次数: 9
摘要
导读:在全球范围内,由于治疗选择相对较少,与肝细胞癌(HCC)相关的发病率和死亡率正在上升。原发性肝硬化是导致HCC最常见的病因,但肝硬化的危险因素表现出很大的区域差异。多年来,HCC的诊断和治疗方式稳步发展,包括广泛的全身化疗药物的可用性。我们旨在回顾HCC诊断和治疗策略的最新进展。方法:使用PubMed、Cochrane和Science Direct数据库进行文献检索,并对最新的相关文章进行综述。结果:HCC筛查是早期诊断的关键一步。目前的指导方针建议使用超声波和甲胎蛋白,但各种新的生物标志物正在积极研究中,可能有助于诊断非常小的肿瘤,目前的筛查方法无法检测到。根据巴塞罗那分类,治疗方案是根据患者的整体表现和疾病程度来决定的。只有很少的选择可以治愈这种疾病,从肝脏切除和移植到肿瘤消融。降低分期已被证明在疾病的过程中起着重要作用。控制疾病的尝试可以通过放射干预,如经动脉化疗栓塞、经动脉放射栓塞或放射治疗。对于晚期疾病,索拉非尼曾经是唯一的选择,直到几年前。最近,许多其他全身性药物已被批准作为HCC的一线和二线治疗。基因组学是一个活跃的临床研究领域,因为了解HCC演变过程中的突变和基因组学可能会带来突破性的治疗。引用方式:Raees A, Kamran M, Özkan H,等。肝细胞癌的诊断和治疗进展。中华肝病杂志;2011;11(1):32-40。
Updates on the Diagnosis and Management of Hepatocellular Carcinoma.
Introduction: Globally, the incidence, as well as mortality, related to hepatocellular carcinoma (HCC) is on the rise, owing to relatively few curative options. Underlying cirrhosis is the most common etiology leading to HCC, but risk factors of cirrhosis show great regional variability. Over the years, there has been a steady development in the diagnostic and therapeutic modalities of HCC, including the availability of a wide range of systemic chemotherapeutic agents. We aim to review the recent advancements in the diagnostic and therapeutic strategies for HCC.
Methodology: The literature search was done using databases PubMed, Cochrane, and Science Direct, and the latest relevant articles were reviewed.
Findings: Screening of HCC is a pivotal step in the early diagnosis of the disease. Current guidelines recommend using ultrasound and alfa fetoprotein but various new biomarkers are under active research that might aid in diagnosing very small tumors, not picked up by the current screening methods. Treatment options are decided based upon the overall performance of the patient and the extent of the disease, as per the Barcelona classification. There are very few options that offer a cure for the disease, ranging from liver resection and transplantation to tumor ablation. Downstaging has proven to have a significant role in the course of the disease. An attempt to control the disease can be made via radiological interventions, such as transarterial chemoembolization, transarterial radioembolization, or radiation therapy. For advanced disease, sorafenib used to be the only option until a couple of years ago. Recently, many other systemic agents have received approval as first-line and second-line therapies for HCC. Genomics is an area of active clinical research as understanding the mutations and genomics involved in the evolution of HCC might lead to a breakthrough therapy.
How to cite this article: Raees A, Kamran M, Özkan H, et al. Updates on the Diagnosis and Management of Hepatocellular Carcinoma. Euroasian J Hepato-Gastroenterol 2021;11(1):32-40.