肝细胞癌个体化治疗的临床预测模型

王葵; 邹奇飞; 沈锋; 李征; 尉文新; 夏勇; 李俊; 阎振林

doi:10.3969/j.issn.1001-5256.2018.07.004

肝细胞癌个体化治疗的临床预测模型

DOI: 10.3969/j.issn.1001-5256.2018.07.004

1. 上海东方肝胆外科医院肝外二科
2. 上海东方肝胆外科医院肝外四科

基金项目:

中国传染病重大专项课题(2018ZX10723204)；上海申康医院发展中心市级医院新兴前沿技术联合攻关项目(SHDC12017122)；

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2018-05-11
- 出版日期: 2018-07-20

Clinical predictive models for individualized treatment of hepatocellular carcinoma

Second Department of Liver Surgery, Eastern Hepatobiliary Surgery Hospital

Research funding:

摘要

摘要: 肝细胞癌(HCC)往往伴有肝炎和肝硬化,根据其疾病分期、肿瘤部位及肝功能等情况进行精准治疗的要求很高。临床上多种诊疗方法均对HCC具有一定的疗效,故如何有效地对患者进行预后分析,从而选择合适的个体化治疗方案,成为亟需解决的问题。针对HCC的预后,有多种预测系统,其中列线图因能够较好地针对HCC患者进行个体化分析而备受关注。目前,根据不同类型的HCC已建立了多种列线图预测模型,这些模型纳入了一些临床和病理指标,如肿瘤标志物、肝功能、HBV指标、微血管癌栓等,其对不同患者计算出不同的风险评分,能够较好地预测预后。同时,可以根据不同的风险等级指导患者选择合适的治疗方式和术后抗复发治疗,从而达到个体化治疗的目的。
- 癌,肝细胞 /
- 列线图 /
- 治疗,计算机辅助
Abstract: Hepatocellular carcinoma ( HCC) is one of the most common malignant tumors in China and has high incidence and mortality rates. HCC is often accompanied by hepatitis and liver cirrhosis, and therefore, there is high demand for precise treatment based on disease stage, tumor location, and liver function. Various diagnostic and treatment methods used in clinical practice have a certain therapeutic effect on HCC, and the issue of effective prognostic analysis and selection of individualized treatment regimen needs to be solved urgently. There are many predictive systems for the prognosis of HCC, among which nomogram can better help with the individualized analysis of HCC patients and has thus attracted more and more attention. At present, various nomographic predictive models have been established for different types of HCC; such models integrate some clinical and pathological indices, such as tumor markers, liver function, HBV indices, and microvascular tumor thrombus, and then risk score is calculated for each patient to predict prognosis. Meanwhile, clinicians can select the appropriate therapeutic method and postoperative anti-recurrence treatment based on the level of risk to achieve the goal of individualized treatment.
- carcinoma, hepatocellular /
- nomograms /
- therapy, computer-assisted

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参考文献(41)

[1]WANG FS, FAN JG, ZHANG Z, et al.The global burden of liver disease:The major impact of China[J].Hepatology, 2014, 60 (6) :2099-2108.

[2]WU J, YANG S, XU K, et al.Patterns and trends of liver cancer incidence rates in eastern and southeastern Asian countries (1983-2007) and predictions to 2030[J].Gastroenterology, 2018, 154 (6) :1719-1728.

[3]FORNER A, GILABERT M, BRUIX J, et al.Treatment of intermediate-stage hepatocellular carcinoma[J].Nat Rev Clin Oncol, 2014, 11 (9) :525-535.

[4]BRUIX J, SHERMAN M, American Association for the Study of Liver Diseases.Management of hepatocellular carcinoma:An update[J].Hepatology, 2011, 53 (3) :1020-1022.

[5]VAUTHEY JN, LAUWERS GY, ESNAOLA NF, et al.Simplified staging for hepatocellular carcinoma[J].J Clin Oncol, 2002, 20 (6) :1527-1536.

[6]Ministry of Health of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2011) [J].J Clin Hepatol, 2011, 27 (11) :1141-1159. (in Chinese) 中华人民共和国卫生部.原发性肝癌诊疗规范 (2011年版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1159.

[7]BENSON AB 3rd, D'ANGELICA MI, ABBOTT DE, et al.NCCN guidelines insights:Hepatobiliary cancers, version 1.2017[J].J Natl Compr Canc Netw, 2017, 15 (5) :563-573.

[8]MARRERO JA, AHN J, RAJENDER REDDY K, et al.ACG clinical guideline:The diagnosis and management of focal liver lesions[J].Am J Gastroenterol, 2014, 109 (9) :1328-1347.

[9] HEIMBACH JK, KULIK LM, FINN RS, et al.AASLD guidelines for the treatment of hepatocellular carcinoma[J].Hepatology, 2018, 67 (1) :358-380.

[10]European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer.EASL-EORTC clinical practice guidelines:Management of hepatocellular carcinoma[J].J Hepatol, 2012, 56 (4) :908-943.

[11]National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

[12]AMIN MB.AJCC cancer staging manual (8th edition) [M].Chicago:Springer, 2017:185-202.

[13]FORNER A, REIG M, BRUIX J.Hepatocellular carcinoma[J].Lancet, 2018, 391 (10127) :1301-1314.

[14]KOH WJ, ABU-RUSTUM NR, BEAN S, et al.Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw, 2018, 16 (2) :170-199.

[15]European Association for the Study of the Liver.EASL clinical practice guidelines:Management of hepatocellular carcinoma[J].J Hepatol, 2018.[Epub ahead of print]

[16]MAZZAFERRO V, REGALIA E, DOCI R, et al.Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis[J].N Engl J Med, 1996, 334 (11) :693-699.

[17]YAO FY, FERRELL L, BASS NM, et al.Liver transplantation for hepatocellular carcinoma:Expansion of the tumor size limits does not adversely impact survival[J].Hepatology, 2001, 33 (6) :1394-1403.

[18]FAN J, YANG GS, FU ZR, et al.Liver transplantation outcomes in1, 078 hepatocellular carcinoma patients:A multi-center experience in Shanghai, China[J].J Cancer Res Clin Oncol, 2009, 135 (10) :1403-1412.

[19]LI J, YAN LN, YANG J, et al.Indicators of prognosis after liver transplantation in Chinese hepatocellular carcinoma patients[J].World J Gastroenterol, 2009, 15 (33) :4170-4176.

[20]ZHENG SS, XU X, WU J, et al.Liver transplantation for hepatocellular carcinoma:Hangzhou experiences[J].Transplantation, 2008, 85 (12) :1726-1732.

[21]IASONOS A, SCHRAG D, RAJ GV, et al.How to build and interpret a nomogram for cancer prognosis[J].J Clin Oncol, 2008, 26 (8) :1364-1370.

[22]KARAKIEWICZ PI, BRIGANTI A, CHUN FK, et al.Multi-institutional validation of a new renal cancer-specific survival nomogram[J].J Clin Oncol, 2007, 25 (11) :1316-1322.

[23]van ZEE KJ, MANASSEH DM, BEVILACQUA JL, et al.A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel node biopsy[J].Ann Surg Oncol, 2003, 10 (10) :1140-1151.

[24]STERNBERG CN.Are nomograms better than currently available stage groupings for bladder cancer?[J].J Clin Oncol, 2006, 24 (24) :3819-3820.

[25]LI J, ZHOU J, YANG PH, et al.Nomograms for survival prediction in patients undergoing liver resection for hepatitis B virus related early stage hepatocellular carcinoma[J].Eur J Cancer, 2016, 62:86-95.

[26]LI Y, XIA Y, LI J, et al.Prognostic nomograms for pre-and postoperative predictions of long-term survival for patients who underwent liver resection for huge hepatocellular carcinoma[J].J Am Coll Surg, 2015, 221 (5) :962-974.

[27]YANG P, QIU J, LI J, et al.Nomograms for pre-and postoperative prediction of long-term survival for patients who underwent hepatectomy for multiple hepatocellular carcinomas[J].Ann Surg, 2016, 263 (4) :778-786.

[28]ZOU Q, LI J, WU D, et al.Nomograms for pre-operative and post-operative prediction of long-term survival of patients who underwent repeat hepatectomy for recurrent hepatocellular carcinoma[J].Ann Surg Oncol, 2016, 23 (8) :2618-2626.

[29]LI J, LIU Y, YAN Z, et al.A nomogram predicting pulmonary metastasis of hepatocellular carcinoma following partial hepatectomy[J].Br J Cancer, 2014, 110 (5) :1110-1117.

[30]QIAO G, LI J, HUANG A, et al.Artificial neural networking model for the prediction of post-hepatectomy survival of patients with early hepatocellular carcinoma[J].J Gastroenterol Hepatol, 2014, 29 (12) :2014-2020.

[31]DU M, CHEN L, ZHAO J, et al.Microvascular invasion (MVI) is a poorer prognostic predictor for small hepatocellular carcinoma[J].BMC Cancer, 2014, 14:38.

[32]RODRIGUEZ-PERALVAREZ M, LUONG TV, ANDREANA L, et al.A systematic review of microvascular invasion in hepatocellular carcinoma:Diagnostic and prognostic variability[J].Ann Surg Oncol, 2013, 20 (1) :325-339.

[33]ZHOU YM, YANG JM, LI B, et al.Risk factors for early recurrence of small hepatocellular carcinoma after curative resection[J].Hepatobiliary Pancreat Dis Int, 2010, 9 (1) :33-37.

[34]ESNAOLA NF, LAUWERS GY, MIRZA NQ, et al.Predictors of microvascular invasion in patients with hepatocellular carcinoma who are candidates for orthotopic liver transplantation[J].J Gastrointest Surg, 2002, 6 (2) :224-232.

[35]Mc HUGH PP, GILBERT J, VERA S, et al.Alpha-fetoprotein and tumour size are associated with microvascular invasion in explanted livers of patients undergoing transplantation with hepatocellular carcinoma[J].HPB (Oxford) , 2010, 12 (1) :56-61.

[36]HOU Y, ZOU Q, GE R, et al.The critical role of CD133 (+) CD44 (+/high) tumor cells in hematogenous metastasis of liver cancers[J].Cell Res, 2012, 22 (1) :259-272.

[37]WANG K, LIU J, YAN ZL, et al.Overexpression of aspartyl- (asparaginyl) -beta-hydroxylase in hepatocellular carcinoma is associated with worse surgical outcome[J].Hepatology, 2010, 52 (1) :164-173.

[38]CUCCHETTI A, PISCAGLIA F, GRIGIONI AD, et al.Preoperative prediction of hepatocellular carcinoma tumour grade and micro-vascular invasion by means of artificial neural network:A pilot study[J].J Hepatol, 2010, 52 (6) :880-888.

[39]LEI Z, LI J, WU D, et al.Nomogram for preoperative estimation of microvascular invasion risk in hepatitis B virus-related hepatocellular carcinoma within the Milan criteria[J].JAMA Surg, 2016, 151 (4) :356-363.

[40]HUANG A, ZHAO X, YANG XR, et al.Circumventing intratumoral heterogeneity to identify potential therapeutic targets in hepatocellular carcinoma[J].J Hepatol, 2017, 67 (2) :293-301.

[41]XIA Y, QIU Y, LI J, et al.Adjuvant therapy with capecitabine postpones recurrence of hepatocellular carcinoma after curative resection:A randomized controlled trial[J].Ann Surg Oncol, 2010, 17 (12) :3137-3144.

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