摘要
肝癌的研究在近半个世纪取得了很大进步。由于进一步弄清了病因因素，肝癌的预防已经有了可能，包括新生儿乙 型肝炎疫苗接种、通过干扰素治疗肝炎以及改良饮水等，使肝癌的发病率降低。一组前瞻性随机分组筛查试验提示筛查确能降低 肝癌死亡率。肝癌标记和影像医学的进步。使１ｃｍ的小肝癌也不难检出。手术切除在改善肝癌预后方面继续起关键作用。我所４１５ 例生存５年以上的病人中，９５．４％曾接受一期或二期切除；１１０６例小肝癌切除的５年生存率达６３．７％； １０９例不能切除肝癌经姑 息性外科治疗缩小后切除的５年生存率达６２．２％。大系列的肝癌切除和肝移植的对比分析，提示肝移植只适于因肝功能差而不 宜切除的小肝癌。单一外科治疗已被外科为主、局部治疗为辅、多种模式有机结合”所代替。临床研究强调“以证据为基础”，惜经 证实对肝癌有效的药物不多。肝癌复发转移的研究将成为２１世纪的研究重点。
In the recent decades, advances have been made in the studies of hepatocellular carcinoma (HCC ). Based on the further understanding of etiological factors involved in HCC, prevention of HCC is possible. Using hepatitis B vaccination in newborn babies, interferon therapy to control viral hepatitis B and C and improve quality of drinking water, HCC incidence has decreased. A prospective randomized control screening trial has indicated that screening decreased HCC mortality. Currently a 1 cm HCC is not difficult to he detected based on the progress of tumor marker and medical imaging. Surgical resection remains to play a key role to improve HCC Prognosis. Of the 415 HCC patients who survived more than 5 years, 95 .4% of them received either 1st stage or 2nd stage resection. The 5 -- year survival of 1106 patients with small HCC resection was up to 63. 7%. In a group or 109 patients who had initially unresectable HCC treated by Palliative surgery other than resection, and received 2nd stage resection after shrinkage of tumor, the 5 -- year survival was up to 62. 2%. Comparison of large series of liver transplantation and resection for HCC demonstrates that transplantation is only suitable for small HCC, not suitable for resection due to liver dys- function. The treatment pattern of HCC has been changed from surgery to a combination of surgery, regional cancer therapies and their multimodality combination. Evidence based' is currently advocated in clinical research, unfortunately, very few effective drug for HCC has been confirmed. Recurrence and metastasis will be an important target to he studied in the 21 century.
出处
《中国肿瘤》
CAS
2001年第1期37-40,共4页
China Cancer
关键词
癌
肝细胞
预防
复发
肿瘤转移
肝肿瘤
诊断
筛查
外科手术
生存率
综合疗法
carcinoma hepatocellular
prevention
recurrence
neoplasm metastasis
liver neoplasms
diagnosis
screening
surgery
survirul rate
comprehensive therapy
