肝细胞癌的筛查与监测

肝脏 ›› 2021, Vol. 26 ›› Issue (10): 1075-1077.

肝细胞癌的筛查与监测

黄飞虎, 余姣, 万谟彬

200433 上海海军军医大学长海医院感染科

收稿日期:2021-09-29 出版日期:2021-10-31 发布日期:2021-12-07
通讯作者: 万谟彬,Email:mobinwan@aliyun.com;余姣,Email: yujiao7828@sina.com

Received:2021-09-29 Online:2021-10-31 Published:2021-12-07

摘要/Abstract

摘要： 肝细胞癌(HCC)是全球第六大常见恶性肿瘤和第四大肿瘤致死病因。很多国家和地区的临床指南呼吁对高危人群进行HCC筛查与监测,以期尽早发现,以便实施治愈性治疗,从而减少HCC导致的死亡。但目前HCC监测证据并未得到“金标准”——前瞻性随机对照试验(RCT)的验证。在精准医疗大趋势下,重新审视RCT,结合全球HCC监测做得最好的日本数据显示,对高危人群HCC 筛查与监测有助于及早发现癌症并提高总体生存率。我们需要认识到,与肿瘤切除、肝移植一样,HCC筛查与监测在无需RCT的情况下就应该被纳入实践。致力于改善该疾病患者目前的惨淡结局、有效减轻HCC的社会负担,我们需要以更务实的筛查与监测策略:细化高危人群风险分层,排除低风险人群和不能从监测中获益的终晚期患者免于监测,而将更多的高危人群纳入到监测人群中来,在有限的医疗资源条件下实现HCC筛查与监测价值的最大化。

关键词: 肝细胞癌, 筛查与监测, 随机对照试验, 风险评估

黄飞虎, 余姣, 万谟彬. 肝细胞癌的筛查与监测[J]. 肝脏, 2021, 26(10): 1075-1077.

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