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《原发性肝癌诊疗指南（2026年版）》解读
DOI: 10.12449/JCH260713
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：倪彦彬负责撰写论文；朱继业参与修改论文；李照负责拟定写作思路，指导撰写文章并最后定稿。
Interpretation of guidelines for the diagnosis and treatment of primary liver cancer (2026 edition)
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摘要: 2026年4月，国家卫生健康委员会发布《原发性肝癌诊疗指南（2026年版）》，该版指南将“预防、筛查和监测”独立成章，构建分层精准防控体系；确立以手术为目标的综合治疗模式，明确转化与新辅助治疗核心地位；更新介入与系统治疗推荐，强化基础肝病全程管理。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 April 2026， the National Health Commission of the People’s Republic of China released Guidelines for the diagnosis and treatment of primary liver cancer （2026 edition）. This edition incorporates an independent chapter of “prevention， screening， and monitoring” to build a hierarchical and precise prevention and control system， establishes a comprehensive therapeutic paradigm targeting surgical resection， and clarifies the core position of conversion therapy and neoadjuvant therapy. It also updates the recommendations for interventional and systemic therapies and strengthens the whole-course management of underlying liver diseases. This article interprets the key updates of this new edition to better guide clinical practice.
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Key words:
- Liver Neoplasms /
- Diagnosis /
- Therapeutics /
- Practice Guidelines as Topic
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[1] Han B F, Zheng R S, Zeng H M, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4( 1): 47- 53. DOI: 10.1016/j.jncc.2024.01.006. [2] National Health Commission of the People’s Republic of China. Standard for diagnosis and treatment of primary liver cancer(2024 edition)[J]. J Clin Hepatol, 2024, 40( 5): 893- 918. DOI: 10.12449/JCH240508.中华人民共和国国家卫生健康委员会. 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. DOI: 10.12449/JCH240508. [3] National Health Commission of the People’s Republic of China. Guideline for diagnosis and treatment of primary liver cancer(2026 edition)[J]. J Clin Hepatol, 2026, 42( 4): 794- 827. DOI: 10.12449/JCH260409.中华人民共和国国家卫生健康委员会. 原发性肝癌诊疗指南(2026年版)[J]. 临床肝胆病杂志, 2026, 42( 4): 794- 827. DOI: 10.12449/JCH260409. [4] Chan S L, Sun H C, Xu Y, et al. The Lancet Commission on addressing the global hepatocellular carcinoma burden: Comprehensive strategies from prevention to treatment[J]. Lancet, 2025, 406( 10504): 731- 778. DOI: 10.1016/S0140-6736(25)01042-6. [5] Fan R, Papatheodoridis G, Sun J, et al. aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis[J]. J Hepatol, 2020, 73( 6): 1368- 1378. DOI: 10.1016/j.jhep.2020.07.025. [6] Fan R, Chen L, Zhao S R, et al. Novel, high accuracy models for hepatocellular carcinoma prediction based on longitudinal data and cell-free DNA signatures[J]. J Hepatol, 2023, 79( 4): 933- 944. DOI: 10.1016/j.jhep.2023.05.039. [7] Vitale A, Romano P, Cillo U, et al. Liver resection vs nonsurgical treatments for patients with early multinodular hepatocellular carcinoma[J]. JAMA Surg, 2024, 159( 8): 881- 889. DOI: 10.1001/jamasurg.2024.1184. [8] Liu R, Abu Hilal M, Wakabayashi G, et al. International experts consensus guidelines on robotic liver resection in 2023[J]. World J Gastroenterol, 2023, 29( 32): 4815- 4830. DOI: 10.3748/wjg.v29.i32.4815. [9] Chiang C L, Chan K S K, Chiu K W H, et al. Complete response to locoregional therapy plus immunotherapy for hepatocellular carcinoma[J]. JAMA Oncol, 2024, 10( 11): 1548- 1553. DOI: 10.1001/jamaoncol.2024.4085. [10] Wang Z, Fan J, Zhou S L, et al. Perioperative camrelizumab plus rivoceranib versus surgery alone in patients with resectable hepatocellular carcinoma at intermediate or high risk of recurrence(CARES-009): A randomised phase 2/3 trial[J]. Lancet, 2025, 406( 10515): 2089- 2099. DOI: 10.1016/S0140-6736(25)01720-9. [11] Dong J, Han G, Ogasawara S, et al. LBA2 TALENTACE: A phase III, open-label, randomized study of on-demand transarterial chemoembolization(TACE) combined with atezolizumab + bevacizumab(Atezo+Bev) or on-demand TACE alone in patients with systemically untreated, intermediate-to-high burden unresectable hepatocellular carcinoma(uHCC)[J]. Ann Oncol, 2025, 36: S62. DOI: 10.1016/j.annonc.2025.05.542. [12] Kudo M, Ren Z G, Guo Y B, et al. Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma(LEAP-012): A multicentre, randomised, double-blind, phase 3 study[J]. Lancet, 2025, 405( 10474): 203- 215. DOI: 10.1016/S0140-6736(24)02575-3. [13] Sangro B, Kudo M, Erinjeri J P, et al. Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma(EMERALD-1): A multiregional, randomised, double-blind, placebo-controlled, phase 3 study[J]. Lancet, 2025, 405( 10474): 216- 232. DOI: 10.1016/S0140-6736(24)02551-0. [14] Yau T, Galle P R, Decaens T, et al. Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma(CheckMate 9DW): An open-label, randomised, phase 3 trial[J]. Lancet, 2025, 405( 10492): 1851- 1864. DOI: 10.1016/S0140-6736(25)00403-9. [15] Xu J M, Zhang Y Q, Wang G, et al. SCT-I10A combined with a bevacizumab biosimilar(SCT510) versus sorafenib in the first-line treatment of advanced hepatocellular carcinoma: A randomized phase 3 trial[J]. J Clin Oncol, 2024, 42( 16_suppl): 4092. DOI: 10.1200/jco.2024.42.16_suppl.4092. [16] Shi Y H, Han G H, Zhou J, et al. Toripalimab plus bevacizumab versus sorafenib as first-line treatment for advanced hepatocellular carcinoma(HEPATORCH): A randomised, open-label, phase 3 trial[J]. Lancet Gastroenterol Hepatol, 2025, 10( 7): 658- 670. DOI: 10.1016/S2468-1253(25)00059-7. [17] Zhou J, Bai L, Luo J, et al. Anlotinib plus penpulimab versus sorafenib in the first-line treatment of unresectable hepatocellular carcinoma(APOLLO): A randomised, controlled, phase 3 trial[J]. Lancet Oncol, 2025, 26( 6): 719- 731. DOI: 10.1016/S1470-2045(25)00190-1. -
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