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Multidisciplinary perspective of hepatocellular carcinoma: A Pacific Northwest experience

World Journal of Hepatology 2015年第11期7卷 1460-1483页

作者： Matthew M Yeh Raymond S Yeung Smith Apisarnthanarax Renuka Bhattacharya Carlos Cuevas William P Harris Tony Lim Kiat Hon siddharth a padia James O Park Kevin M Riggle Sayed S Daoud Department of Pathology University of Washington School of Medicine Department of Medicine University of Washington School of Medicine Northwest Liver Research Program Depart-ment of Surgery University of Washington School of Medicine Department of Radiation Oncology University of Washington School of Medicine Department of Radiology University of Washington School of Medicine Seattle Department of Pathology Singapore General Hospital Department of Pharmaceutical Sciences Washington State University Health Sciences

Hepatocellular carcinoma(HCC) is the most rapidly increasing type of cancer in the United States. HCC is a highly malignant cancer, accounting for at least 14000 deaths in the United States annually, and it ranks third as a cause of cancer mortality in men. One major difficulty is that most patients with HCC are diagnosed when the disease is already at an advanced stage, and the cancer cannot be surgically removed. Furthermore, because almost all patients have cirrhosis, neither chemotherapy nor major resections are well tolerated. Clearly there is need of a multidisciplinary approach for the management of HCC. For example, there is a need for better understanding of the fundamental etiologic mechanisms that are involved in hepatocarcinogenesis, which could lead to the development of successful preventive and therapeutic modalities. It is also essential to define the cellular and molecular bases for malignant transformation of hepatocytes. Such knowledge would:(1) greatly facilitate the identification of patients at risk;(2) prompt efforts to decrease risk factors; and(3) improve surveillance and early diagnosis through diagnostic imaging modalities. Possible benefits extend also to the clinical management of this disease. Because there are many factors involved in pathogenesis of HCC,this paper reviews a multidisciplinary perspective of recent advances in basic and clinical understanding of HCC that include: molecular hepatocarcinogenesis, noninvasive diagnostics modalities, diagnostic pathology, surgical modality, transplantation, local therapy and oncological/target therapeutics.

关键词： Genetic alterations Epigenetic alterations Diagnostic pathology Diagnostic imaging Surgicalmodality Liver transplantation Locoregional therapy Sorafenib Hepatocellular carcinoma Liver resection

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