肝细胞癌流行病学的全球趋势:对查,预防和治疗的影响
Amit G Singal1, Fasiha Kanwal2,3,4,5, Josep M Llovet6,7,8
1Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA. amit.singal@utsouthwestern.edu.
Nature reviews. Clinical oncology
|October 26, 2023
概括
肝细胞癌 (HCC) 在全球上升,转向非病毒性原因. 目前的监测缺乏敏感性,凸显了对这种肝癌更好的查和预防策略的需要.
科学领域:
- 肝病学和瘤学 肝病学和瘤学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 肝细胞癌 (HCC) 死亡率在全球范围内不断增加,病毒性病因明显转向非病毒性病因,如与酒精相关的和与代谢功能障碍相关的脂肪性肝病.
- 肝硬化仍然是主要的风险因素,但不断变化的流行病学趋势需要更新的预防和监测方法.
研究的目的:
- 审查肝细胞癌 (HCC) 流行病学的当前趋势.
- 讨论这些趋势对HCC查,预防和治疗的影响.
- 突出非病毒性肝病化学预防方面的未满足需求以及当前监测工具的局限性.
主要方法:
- 对HCC发病率和死亡率的流行病学数据的审查.
- 分析目前的预防策略,包括疫苗接种和抗病毒疗法.
- 评估现有和新兴的监控工具及其局限性.
- 讨论HCC治疗方式的最新进展.
主要成果:
- 在西方国家,HCC发病率的增加是由非病毒性肝病驱动的.
- 当前监测方法 (如超声波) 在特定患者群体 (肥胖,非病毒性肝病) 的有效性有限.
- 新兴但未经证实的化疗预防剂 (阿司匹林,他类药物,甲胺,咖啡) 和先进的监测技术.
结论:
- 转向非病毒性HCC的转变需要新的化学预防和改进的监测策略.
- 在等待新方法的验证时,最大限度地使用当前的监控工具至关重要.
- 在HCC治疗方面取得的重大进展提供了更多的选择,包括免疫疗法,但早期检测仍然是降低死亡率的关键.
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