【文献解读】口服抗病毒治疗在乙型肝炎相关肝细胞癌中的作用
2017/11/30 创新医学网

    

    

     文章来源:欧尔意 OAE 微信号

     作者 :sofina

    

     1原文出处

     Fung J, Chok KSH. The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma. Hepatoma Res 2017;3: 284-93.

     DOI:10.20517/2394-5079.2017.38

     2摘要

     乙型肝炎病毒(HBV)是慢性乙型肝炎感染流行地区发生肝细胞癌(HCC)的主要原因。口服核苷(酸)类似物(NA)疗法可降低HCC的风险,但不能完全阻止其发展。对于HBV相关的HCC,NAs对病毒的抑制可以保持或改善肝功能,从而增加治疗干预的机会。手术切除后,NAs可以防止HBV的再激活,并且还可以减少残肝中HCC的复发的机会。对于接受肝移植的患者来说,NAs对于防止再激活和移植肝炎至关重要,但由于转移性疾病好像不能预防HCC复发。NAs对非可治愈晚期HCC的作用尚不明确。这些包括正在进行局部治疗,化疗或姑息治疗的患者。尽管抗病毒治疗可以保护肝功能,而肝功能可能会受到HBV的危害,但不能阻止HCC的进展。在HCC诊断时,大多数患者将已经接受NAs,这些患者应该继续接受治疗。对于HCC诊断时未进行抗病毒治疗的患者,开始治疗的决定通常取决于HCC的阶段和预期寿命。接受抗病毒治疗或具有合理预期寿命的局部治疗/化疗的患者,应开始抗病毒治疗。

     关键词:抗病毒治疗,乙肝病毒,肝细胞癌

     Abstract:Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) in places where chronic hepatitis B infection is endemic. Oral nucleos(t)ide analog (NA) therapy can reduce the risk of HCC, but cannot completely prevent its development. For HBV-related HCCs, viral inhibition by NAs can preserve or improve liver function, thereby increasing the chance of therapeutic intervention. After surgical resection, NAs can prevent reactivation of HBV, and also reduce the chance of de novo development of HCC in the remnant liver. For those who undergo liver transplantation, NAs are essential to prevent reactivation and graft hepatitis, but is not likely to prevent HCC recurrence, which is due to metastatic disease. The role of NAs for non-curable advanced HCC is less well defined. These include patients undergoing locoregional therapy, chemotherapy, or palliation. Although antiviral therapy can preserve liver function, which may be compromised by HBV, it is unable to prevent disease progression from HCC. At the time of HCC diagnosis, most patients will already be receiving NAs, and these patients should be maintained on therapy. For patients not on antiviral therapy at the time of HCC diagnosis, the decision to commence therapy is often determined by the stage of HCC and life expectancy. Patients undergoing curative therapy, or locoregional therapy/chemotherapy with reasonable life expectancy, should be commenced on antiviral therapy.

     Keywords:Antiviral therapy, hepatitis B virus, hepatocellular carcinoma

     3原文链接

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     4联系我们

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     中文摘要内容由OAE Publishing Inc. 北京办公室负责翻译。中文内容仅供参考,一切内容以英文原版为准。

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