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《原发性肝癌诊疗指南（2024年版）》解读
DOI: 10.12449/JCH240707
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：李照负责课题设计，撰写论文；朱继业负责拟定写作思路，指导撰写文章并最后定稿。
Interpretation of guidelines for the diagnosis and treatment of primary liver cancer （2024 edition）
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摘要: 2017年6月国家卫生和计划生育委员会发布了《原发性肝癌诊疗规范（2017年版）》，该规范在肝癌的诊断、分期及治疗方面提出推荐性意见具有重要意义，此后国内外在原发性肝癌研究方面不断出现符合循证医学原则的高级别证据。为此，国家卫生健康委员会修订更新颁布了《原发性肝癌诊疗指南（2024年版）》，本文对新版指南的更新要点进行解读，以期更好地指导临床 。Abstract: In June 2017， National Health Commission of the People’s Republic of China released Guidelines for the diagnosis and treatment of primary liver cancer （2017 edition）， which provided important recommendations for the diagnosis， staging， and treatment of liver cancer. Since then， high-level evidence in line with the principles of evidence-based medicine has been continuously obtained from the research on primary liver cancer in China and globally. Therefore， National Health Commission released Guidelines for the diagnosis and treatment of primary liver cancer （2024 edition）. This article gives an interpretation of the updated key points in the guidelines， in order to better guide clinical practice.
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[1] General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer(2022 edition)[J]. J Clin Hepatol, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009. [2] General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer(2024 edition)[J]. J Clin Hepatol, 2024, 40( 5): 893- 918.国家卫生健康委办公厅. 原发性肝癌诊疗指南(2024年版)[J]. 临床肝胆病杂志, 2024, 40( 5): 893- 918. [3] FAN PL, XIA HS, DING H, et al. Characterization of early hepatocellular carcinoma and high-grade dysplastic nodules on contrast-enhanced ultrasound: Correlation with histopathologic findings[J]. J Ultrasound Med, 2020, 39( 9): 1799- 1808. DOI: 10.1002/jum.15288. [4] CHEN YL, LU Q, ZHU YL, et al. Prediction of microvascular invasion in combined hepatocellular-cholangiocarcinoma based on pre-operative clinical data and contrast-enhanced ultrasound characteristics[J]. Ultrasound Med Biol, 2022, 48( 7): 1190- 1201. DOI: 10.1016/j.ultrasmedbio.2022.02.014. [5] DING WZ, WANG Z, LIU FY, et al. A hybrid machine learning model based on semantic information can optimize treatment decision for Naïve single 3-5-cm HCC patients[J]. Liver Cancer, 2022, 11( 3): 256- 267. DOI: 10.1159/000522123. [6] HUANG P, NI XY, ZHOU CW, et al. Subcentimeter nodules with diagnostic hallmarks of hepatocellular carcinoma: Comparison of pathological features and survival outcomes with nodules measuring 1-2 cm[J]. J Hepatocell Carcinoma, 2023, 10: 169- 180. DOI: 10.2147/JHC.S401027. [7] GUO W, SUN YF, SHEN MN, et al. Circulating tumor cells with stem-like phenotypes for diagnosis, prognosis, and therapeutic response evaluation in hepatocellular carcinoma[J]. Clin Cancer Res, 2018, 24( 9): 2203- 2213. DOI: 10.1158/1078-0432.CCR-17-1753. [8] QU CF, WANG YT, WANG P, et al. Detection of early-stage hepatocellular carcinoma in asymptomatic HBsAg-seropositive individuals by liquid biopsy[J]. Proc Natl Acad Sci U S A, 2019, 116( 13): 6308- 6312. DOI: 10.1073/pnas.1819799116. [9] HUANG YH, ZHANG CZ, HUANG QS, et al. Clinicopathologic features, tumor immune microenvironment and genomic landscape of Epstein-Barr virus-associated intrahepatic cholangiocarcinoma[J]. J Hepatol, 2021, 74( 4): 838- 849. DOI: 10.1016/j.jhep.2020.10.037. [10] Expert Committee for Writing the Expert Consensus on Pathological Diagnosis of Intrahepatic cholangiocarcinoma( 2022 version). Expert consensus on pathological diagnosis of intrahepatic cholangiocarcinoma(2022 version)[J]. Chin J Pathol, 2022, 51( 9): 819- 827. DOI: 10.3760/cma.j.cn112151-20220517-00423.《肝内胆管癌病理诊断专家共识(2022版)》编写专家委员会. 肝内胆管癌病理诊断专家共识(2022版)[J]. 中华病理学杂志, 2022, 51( 9): 819- 827. DOI: 10.3760/cma.j.cn112151-20220517-00423. [11] WANG H, CHEN JJ, YIN SY, et al. A grading system of microvascular invasion for patients with hepatocellular carcinoma undergoing liver resection with curative intent: A multicenter study[J]. J Hepatocell Carcinoma, 2024, 11: 191- 206. DOI: 10.2147/JHC.S447731. [12] MIRDAD RS, MADISON HYER J, DIAZ A, et al. Postoperative imaging surveillance for hepatocellular carcinoma: How much is enough?[J]. J Surg Oncol, 2021, 123( 7): 1568- 1577. DOI: 10.1002/jso.26433. [13] XIA Y, LI J, LIU GH, et al. Long-term effects of repeat hepatectomy vs percutaneous radiofrequency ablation among patients with recurrent hepatocellular carcinoma: A randomized clinical trial[J]. JAMA Oncol, 2020, 6( 2): 255- 263. DOI: 10.1001/jamaoncol.2019.4477. [14] XU XL, LIU XD, LIANG M, et al. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma: Systematic review of randomized controlled trials with meta-analysis and trial sequential analysis[J]. Radiology, 2018, 287( 2): 461- 472. DOI: 10.1148/radiol.2017162756. [15] YANG PH, SI AF, YANG J, et al. A wide-margin liver resection improves long-term outcomes for patients with HBV-related hepatocellular carcinoma with microvascular invasion[J]. Surgery, 2019, 165( 4): 721- 730. DOI: 10.1016/j.surg.2018.09.016. [16] WANG Q, LI HJ, DAI XM, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: Systematic review and meta-analysis of propensity-score matched studies[J]. Int J Surg, 2022, 105: 106821. DOI: 10.1016/j.ijsu.2022.106821. [17] QIN SK, CHEN MS, CHENG AL, et al. Atezolizumab plus bevacizumab versus active surveillance in patients with resected or ablated high-risk hepatocellular carcinoma(IMbrave050): A randomised, open-label, multicentre, phase 3 trial[J]. Lancet, 2023, 402( 10415): 1835- 1847. DOI: 10.1016/S0140-6736(23)01796-8. [18] ZHANG YJ, CHEN MS, CHEN Y, et al. Long-term outcomes of transcatheter arterial chemoembolization combined with radiofrequency ablation as an initial treatment for early-stage hepatocellular carcinoma[J]. JAMA Netw Open, 2021, 4( 9): e2126992. DOI: 10.1001/jamanetworkopen.2021.26992. [19] LYU N, WANG X, LI JB, et al. Arterial chemotherapy of oxaliplatin plus fluorouracil versus sorafenib in advanced hepatocellular carcinoma: A biomolecular exploratory, randomized, phase III trial(FOHAIC-1)[J]. J Clin Oncol, 2022, 40( 5): 468- 480. DOI: 10.1200/JCO.21.01963. [20] HE MK, LI QJ, ZOU RH, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion: A randomized clinical trial[J]. JAMA Oncol, 2019, 5( 7): 953- 960. DOI: 10.1001/jamaoncol.2019.0250. [21] CHAN AWH, ZHONG JH, BERHANE S, et al. Development of pre and post-operative models to predict early recurrence of hepatocellular carcinoma after surgical resection[J]. J Hepatol, 2018, 69( 6): 1284- 1293. DOI: 10.1016/j.jhep.2018.08.027. [22] PENG ZW, FAN WZ, ZHU BW, et al. Lenvatinib combined with transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma: A phase III, randomized clinical trial(LAUNCH)[J]. J Clin Oncol, 2023, 41( 1): 117- 127. DOI: 10.1200/JCO.22.00392. [23] SU K, GU T, XU K, et al. Gamma knife radiosurgery versus transcatheter arterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus: A propensity score matching study[J]. Hepatol Int, 2022, 16( 4): 858- 867. DOI: 10.1007/s12072-022-10339-2. [24] QIN SK, CHAN SL, GU SZ, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma(CARES-310): A randomised, open-label, international phase 3 study[J]. Lancet, 2023, 402( 10408): 1133- 1146. DOI: 10.1016/S0140-6736(23)00961-3. -
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