首页> 中文期刊> 《临床肝胆病杂志 》 >肝细胞癌诊治中的若干问题

肝细胞癌诊治中的若干问题

             

摘要

随着肝细胞癌(HCC)肿瘤标志物和CT/MRI诊断的应用、手术切除及局部消融等治疗方法的进步,使HCC的5年生存率达到了63.4%.但是由于我国HCC早期诊断水平的不均衡,可进行手术切除的病例仅仅有20%~30%.对于高危人群定期开展血清肿瘤标志物和肝脏超声检查;提高三期动态增强CT和Gd-DTPA增强MRI等影像学诊断水平,同时积极开展多学科会诊,制定个性化治疗方案和减少术后肝功能衰竭发生等若干问题,是提高我国HCC早期诊断水平,提高治疗效果,延长生存期的有效手段.%Recent advances in hepatocellular carcinoma (HCC) diagnostic methods, including sensitive and specific biomarkers and computed tomography ( CT)/magnetic resonance imaging (MRI) technologies, and therapeutic strategies, such as surgical resection techniques and local ablation methods, have increased the 5 -year survival rate of HCC to 63. 4%. However, early diagnosis remains a clinical challenge in China, and only 20% -30% of cases are suitable for surgical resection upon diagnosis. To improve early diagnosis rates, screening for serum tumor markers should be increased, along with more frequent ultrasound examinations of high-risk individuals, such as those infected with hepatitis virus. In addition, the high-risk populations should be evaluated by more powerful imaging technologies, such as the three-phase dynamic contrast-enhanced CT and the gadopentetic acid ( Gd-DTPA) contrast-enhanced MRI. Upon diagnosis, several aspects of patient management should be enhanced to promote better outcome; specifically, a multidisciplinary consultation approach should be developed to help the patient understand the disease process and healthcare providers to develop effective individualized treatment programs. Collectively, improvements in early diagnosis and patient management will not only help to reduce the rate of late-stage hepatic failure but also improve the overall survival of HCC patients.

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