HBV相关肝细胞癌防治进展

董菁; 江家骥

doi:10.3969/j.issn.1001-5256.2018.07.002

HBV相关肝细胞癌防治进展

DOI: 10.3969/j.issn.1001-5256.2018.07.002

董菁,
江家骥

福建医科大学附属第一医院肝病中心

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2018-04-03
- 出版日期: 2018-07-20

Progress in the prevention and treatment of HBV-related hepatocellular carcinoma

Liver Diseases Research Center, The First Affiliated Hospital of Fujian Medical University

摘要

摘要: HBV相关肝细胞癌（HCC）占目前中国大陆HCC总数的63.9%,HBV通过直接和间接致癌作用2个途径导致HCC产生或复发,理论上抗病毒治疗可以减少或推迟HCC的发生。核苷（酸）类似物（NAs）具有明确的循证医学证据可以减少HCC发生,最新研究提出聚乙二醇干扰素（PEG-IFN）的二级预防作用优于NAs;数据显示NAs可以有效降低治愈性手术后HCC的累积复发率,而IFN的应用可以延长患者的总生存期。HBV相关HCC的二级/三级预防应重视以下2点:重视IFN/PEG-IFN在慢性乙型肝炎患者中的合理应用,将HBV DNA<20 IU/ml和HBs Ag<1000 IU/ml作为治疗的长期控制目标。在抗病毒时代应个体化应用2类抗病毒药物,把HCC的发生率和复发率降到最低。
- 肝炎病毒,乙型 /
- 癌,肝细胞 /
- 综合预防 /
- 治疗
Abstract: Hepatitis B virus ( HBV) -related hepatocellular carcinoma ( HCC) accounts for 63. 9% of all HCC cases in mainland China.HBV leads to the development or recurrence of HCC in a direct or indirect way. Theoretically, anti-HBV therapy can reduce or delay the development of HCC. There has been convincing evidence that nucleos ( t) ide analogues ( NAs) can reduce the development of HCC, and recent studies showed that pegylated interferon ( PEG-IFN) is superior to NAs in secondary prevention; data showed that NAs are effective in reducing the cumulative recurrence rate of HCC after curative surgery, and the application of IFN can extend the overall survival of patients. Secondary/tertiary prevention of HBV-related HCC should focus on the following two points: ( 1) pay attention to the rational use of IFN/PEG-IFN in patients with chronic hepatitis B; ( 2) take HBV DNA < 20 IU/ml and HBs Ag < 1000 IU/ml as the long-term targets of control. In the antiviral era, two types of antiviral drugs should be applied individually to minimize the incidence and recurrence of HCC.
- hepatitis B virus /
- carcinoma, hepatocellular /
- universal precautions /
- therapy

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参考文献(30)

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