浅述肝癌治疗决策中的系统视角

摘要

Currently,as various liver cancer-related treatments in China become developed,doctors also become super-subspecialized.This results in the doctors having more specialized skills and knowledge but a narrower vision.There is a tendency for these super-subspecialists to think and to make decisions based on a narrow perspective.As a consequence,interdisciplinary collaboration is becoming difficult.This hinders further improvement of treatment of liver cancer which has reached a plateau for many years.The present paper proposes a systematic perspective in decisionmaking for treatment of liver cancer.There are seven aspects which include the basic nature of medical care,the history of development of treatment,liver anatomical and functional characteristics,multicentric tumour occurrence,pathology,tumor immunology and biology.We aim to broaden the doctors’ vision and optimize their clinical thinking process.%现阶段,我国肝癌治疗相关领域专业划分越来越细,医生专业范畴和知识面越来越窄.鉴于仅从自身专业视角思考和决策肝癌治疗的倾向愈发明显,学科之间难以形成有效的协作已成为影响肝癌疗效进一步提升的重要原因,肝癌的系统观将可能为进一步提升长期停滞不前的肝癌疗效提供有益帮助.本文从医学本质、临床治疗变迁、肝脏解剖和功能特点、多中心发生规律、病理学、肿瘤免疫学和生物学七个方面阐述肝癌治疗决策中应有的系统观,旨在为拓展医生的肝癌治疗视野和优化临床思维能力提供点滴借鉴.