CAJ | 학술논문

肝细胞癌是临床常见的恶性肿瘤之一,也是全球癌症相关死亡的第二大原因.近年来,肝细胞癌的发病率持续增加,超过一半的病例出现在我国这个乙型肝炎病毒感染为主要致病因素的区域.肝细胞癌存在全球分布的异质性和病因的差异(如西方以丙型肝炎病毒性肝炎和酒精性肝病为主要病因),这可能会导致更为复杂的预后评估和治疗方案选择.在过去的十年中,依据相关的预后因素已经制订了若干的临床分期系统.其中,巴塞罗那分期(BCLC)和香港分期系统(HKLC)是仅有的两个将预后分类与治疗指征相结合的分期系统.在本述评中,我们主要关注BCLC和HKLC分期系统对于肝细胞癌的治疗决策的应用指导意义,并分析各自的优势和缺点,以及新的预后因素纳入分期系统的重要性分析.
간세포암시림상상견적악성종류지일,야시전구암증상관사망적제이대원인.근년래,간세포암적발병솔지속증가,초과일반적병례출현재아국저개을형간염병독감염위주요치병인소적구역.간세포암존재전구분포적이질성화병인적차이(여서방이병형간염병독성간염화주정성간병위주요병인),저가능회도치경위복잡적예후평고화치료방안선택.재과거적십년중,의거상관적예후인소이경제정료약간적림상분기계통.기중,파새라나분기(BCLC)화향항분기계통(HKLC)시부유적량개장예후분류여치료지정상결합적분기계통.재본술평중,아문주요관주BCLC화HKLC분기계통대우간세포암적치료결책적응용지도의의,병분석각자적우세화결점,이급신적예후인소납입분기계통적중요성분석.
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related death worldwide.Increase in incidence has been shown in HCC over the last few years and more than half of the cases were reported in China,where hepatitis B virus (HBV) infection is the main etiologic factor.Heterogeneity in HCC's distribution worldwide and difference in etiology may result in a more complicated issue about prognosis-estimation and choosing of treatment options for HCC patients.In the past decade,there have been several clinical staging systems developed in terms of relevant prognostic factors.Among them,the Barcelona Clinic Liver Cancer (BCLC) and the Hong Kong Liver Cancer (HKLC) staging system are the only two classifications that link prognostic classification to treatment indications.In this review,we mainly focus on the application of BCLC and HKLC staging systems in guiding decision making for HCC,the respective advantages and disadvantages of each classification,and the future perspective of our own prediction model in which some new clinical factors will be integrated.