肝癌特异诊断新标志物发现及其临床应用前景  

Novel specific markers for hepatocellular carcinoma: Perspective on clinical applications

作　　者：方淼[1] 郑文杰[1] 姚敏[1] 董志珍[2] 姚登福[1] 

机构地区：[1]南通大学附属医院临床医学研究中心,江苏省南通市226001 [2]南通大学附属医院诊断学教研室,江苏省南通市226001

出　　处：《世界华人消化杂志》2017年第10期865-873,共9页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.81673241;江苏省重点研发计划基金资助项目;No.BE2016698;国家国际科技合作专项基金资助项目;No.2013DFA32150~~

摘　　要：肝细胞癌(hepatocellular carcinoma,HCC)是全球的最常见的肿瘤之一.虽经持续不懈地根除或改进多种治疗技术,肝癌患者的预后仍很差.如何监测肝细胞的恶性转化或早期诊断HCC仍是医学难题.HCC发病机制复杂,多种致病因素包括乙型肝炎病毒或丙型肝炎病毒的慢性持续感染、脂质积聚和黄曲霉素摄入等致使抗癌基因失活或癌基因复活,诱发肝细胞癌变;HCC患者的早期筛查有益于延长生存期.血甲胎蛋白(alpha-fetoprotein,AFP)和肝癌特异性AFP或A F P-L3作为肿瘤标志虽已常规应用,但他们诊断肝癌仍存在假阳性结果且灵敏度及特异性欠佳.肝癌的有效治疗取决于早期诊断,急需研发比较准确有效标志物用于肝癌患者的早期临床分期,治疗监测与预后判断.近来,积累的资料已显示新的血源性标志物如循环血肿瘤细胞,相关通路关键信号分子、癌胚型特异蛋白、长链非编码RNA和微小RNA对肝癌诊断的潜在价值.本文述评了肝癌特异诊断相关分子标志发现及其应用前景.Hepatocellular carcinoma（HCC） is one of the most common cancers worldwide.Despite continuous global efforts aimed at HCC eradication and improvements in various treatment techniques,the prognosis of HCC remains very poor.How to monitor malignant transformation of hepatocytes or diagnose HCC at early stage is still a medical challenge.A growing understanding of the multiple pathogenic factors including hepatitis B virus or hepatitis C virus infection,lipid accumulation,aflatoxin B1 intake and so on suggests that hepatocarcinogenesis is a multistep process.A large number of oncogenes or tumor suppressor genes have been identified.Early screening of HCC patients has been reported to confer a survival benefit.Although serum alpha-fetoprotein（AFP） and hepatoma-specific AFP have been used as conventional tumor markers,they often show false-positive results and lack sufficient sensitivity and specificity.In order to provide optimal treatment for each patient with HCC,more precise and effective biomarkers are urgently needed in all phases of management from early detection to staging,treatment monitoring,and prognosis evaluation.Recently,numerous studies have shown the clinical utility of novel bloodbased biomarkers,such as circulating tumor cells,key signal molecules or specific proteins,long non-coding RNAs,and microRNAs.In this article,we will review some novel HCCrelated biomarkers and discuss their future perspective on clinical applications.

关 键 词：肝细胞癌 分子标志 特异诊断 临床应用 

分 类 号：R735.7[医药卫生—肿瘤]