Risk factors, early screening, and preventing strategy for hepatitis B-related hepatocellular carcinoma
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摘要: 肝细胞癌(HCC)是全球癌症死亡的主要原因之一,HBV感染是HCC最重要的危险因素之一。HBV相关HCC的发生是宿主与病毒相互作用的复杂过程,危险因素包括HBV病毒载量、HBeAg、宿主易感性等。HCC筛查方式包括超声等影像学检查和AFP等血清标志物,血清异常凝血酶原Ⅱ和AFP异质体有助于诊断AFP阴性HCC。如果采取接种乙型肝炎疫苗、抗病毒治疗等合理措施,可以预防HCC发生。慢性乙型肝炎抗病毒治疗的长远目标在于减少并发症发生,包括肝硬化甚至HCC。核苷类药物抗病毒治疗可有效抑制病毒复制,但无法根除肝细胞核内的cccDNA,治愈乙型肝炎仍然迫在眉睫。综述了HBV相关HCC的流行病学、危险因素、筛查方法和预防策略。Abstract: Hepatocellular carcinoma ( HCC) is a leading cause of cancer-related death worldwide and hepatitis B virus ( HBV) infection isone of most important risk factors for HCC. The development of HBV-related HCC involves a complex interaction between host and virus, and related risk factors include HBV viral load, HBeAg, and host susceptibility. Screening methods for HCC include radiological examina-tion such as ultrasound and serological markers such as α-fetoprotein, and protein induced by vitamin K antagonist-II and alpha-fetopro-tein ( AFP) variants may help with the diagnosis of AFP-negative HCC. Appropriate measures such as HBV vaccination and antiviral thera-py can help to prevent HCC. The long-term goal of antiviral therapy for chronic hepatitis B is to reduce complications such as liver cirrhosisand HCC. nucleos ( t) ide analogues can effectively inhibit replication of virus, but they cannot eradicate covalently closed circular DNA inthe nucleus of hepatocytes. There is still an urgent need for a cure for hepatitis B. This article reviews the epidemiology, risk factors, screening methods, and preventive strategies for HBV-related HCC.
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Key words:
- hepatitis B virus /
- carcinoma, hepatocellular /
- risk factors /
- universal precautions /
- review
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