《2012EASLEORTC肝細胞癌的管理臨床實踐指南》內(nèi)容簡介:
There is a growing incidence of HCC worldwide. Overall, theincidence and mortality rates were of 65,000 and 60,240 casesin Europe and 21,000 and 18,400 cases in the United States in2008, respectively. It is estimated that by 2020 the number ofcases will reach 78,000 and 27,000, respectively .
《2012EASLEORTC肝細胞癌的管理臨床實踐指南》內(nèi)容預(yù)覽:
Cirrhosis is an important risk factor for HCC, and may becaused by chronic viral hepatitis, alcohol, inherited metabolic dis-eases such as hemochromatosis or alpha-1-antitrypsin defi-ciency, and non-alcoholic fatty liver disease. All etiologic formsof cirrhosis may be complicated by tumor formation, but the riskis higher in patients with hepatitis infection. Overall, one-third ofcirrhotic patients will develop HCC during their lifetime .Long-term follow-up studies have demonstrated that approxi-mately 1-8% per year of patients with cirrhosis develop HCC(e.g. 2% in HBV-infected cirrhotic patients and 3-8% in HCV-infected cirrhotic patients) . In general, features of liver dis-ease severity (low platelet count of less than 100 ? 103, presenceof esophageal varices),in addition to older age and male gender,correlate with HCC development among patients with cirrhosis. Recent studies have shown that liver cancer incidenceincreases in parallel to portal pressure as directly measured[13] or in parallel to the degree of liver stiffness as measuredby transient elastography .
Several studies have identified HBV-related factors as key pre-dictors of HCC development in patients with chronic hepatitis Binfection . Hepatitis B virus e antigen (HBeAg) seropositivity, high viral load , and genotype C are independentpredictors of HCC development. In addition, hepatitis B viral loadcorrelates with the risk of progression to cirrhosis . Similarly,in a recent meta-**ysis, HCV genotype 1b is claimed to increasethe risk of HCC development .
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