肝细胞癌临床分期和治疗决策  

Clinical staging and treatment strategy for hepatocellular carcinoma

作　　者：严笑鹏[1] 仇毓东[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肝胆胰外科,南京210008

出　　处：《国际外科学杂志》2015年第7期479-483,F0004,共6页International Journal of Surgery

摘　　要：肝细胞癌是临床常见的恶性肿瘤之一,也是全球癌症相关死亡的第二大原因.近年来,肝细胞癌的发病率持续增加,超过一半的病例出现在我国这个乙型肝炎病毒感染为主要致病因素的区域.肝细胞癌存在全球分布的异质性和病因的差异（如西方以丙型肝炎病毒性肝炎和酒精性肝病为主要病因）,这可能会导致更为复杂的预后评估和治疗方案选择.在过去的十年中,依据相关的预后因素已经制订了若干的临床分期系统.其中,巴塞罗那分期（BCLC）和香港分期系统（HKLC）是仅有的两个将预后分类与治疗指征相结合的分期系统.在本述评中,我们主要关注BCLC和HKLC分期系统对于肝细胞癌的治疗决策的应用指导意义,并分析各自的优势和缺点,以及新的预后因素纳入分期系统的重要性分析.Hepatocellular carcinoma （HCC） is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Increase in incidence has been shown in HCC over the last few years and more than half of the cases were reported in China,where hepatitis B virus （HBV） infection is the main etiologic factor.Heterogeneity in HCC＇s distribution worldwide and difference in etiology may result in a more complicated issue about prognosis-estimation and choosing of treatment options for HCC patients.In the past decade,there have been several clinical staging systems developed in terms of relevant prognostic factors.Among them,the Barcelona Clinic Liver Cancer （BCLC） and the Hong Kong Liver Cancer （HKLC） staging system are the only two classifications that link prognostic classification to treatment indications.In this review,we mainly focus on the application of BCLC and HKLC staging systems in guiding decision making for HCC,the respective advantages and disadvantages of each classification,and the future perspective of our own prediction model in which some new clinical factors will be integrated.

关 键 词：癌 肝细胞 巴塞罗那分期 香港分期 治疗结果 

分 类 号：R735.7[医药卫生—肿瘤]