丙型肝炎病毒根除后的危险因素和肝细胞癌筛查

A. O. Bueverov, P. Bogomolov, V. Syutkin
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引用次数: 0

摘要

肝细胞癌(HCC)通常是在慢性肝病的背景下发展起来的。直到最近,HCC最常见的病因是感染丙型肝炎病毒(HCV)。直接作用抗病毒药物(DAAD)的出现已成为HCV感染治疗的一大突破。现在几乎所有接受治疗的患者,即使是HCC高危人群,主要是肝硬化患者,也能获得稳定的病毒学应答。同时,关于DAAD治疗成功后仍存在恶性转化风险的报道逐渐增多。在丙型肝炎引起的肝硬化负担减轻的同时,非酒精性脂肪性肝病(NAFLD)的病因学作用急剧增加。此外,在相当一部分NAFLD患者中,HCC是在肝硬化前期形成的。HCC病因学和流行病学的这些变化提示患者管理策略的修订
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Risk Factors and Hepatocellular Cancer Screening After Hepatitis C Virus Eradication
Hepatocellular cancer (HCC) usually develops against the background of chronic liver disease. Until recently, the most common etiology of HCC was infection with hepatitis C virus (HCV). The appearance of direct-acting antiviral drugs (DAAD) has become a big breakthrough in the treatment of HCV infection. A stable virological response can now be achieved in almost all treated patients, even in people at high risk of HCC, primarily with cirrhosis of the liver. At the same time, reports gradually began to accumulate about the continued risk of malignant transformation after successful therapy of DAAD. Simultaneously with the decrease in the burden of cirrhosis caused by HCV, the etiological role of non-alcoholic fatty liver disease (NAFLD) has sharply increased. Moreover, in a significant part of patients with NAFLD, HCC is formed at the pre-cirrhotic stage. These changes in the etiology and epidemiology of HCC suggest the revision of patient management tactics
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