Individualized hepatocellular carcinoma risk: The challenges for designing successful chemoprevention strategies

作     者：Cristina Della Corte Alessio Aghemo Massimo Colombo 

作者机构：AM Migliavacca Center for Liver Diseases First Division of Gastroenterology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Università degli Studi di Milano 20122 Milan Italy 

基　　金：Roche Gilead Sciences Merck BMS Gilead Science 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第9期

页      码：1359-1371页

摘      要：Hepatocellular carcinoma (HCC) develops in the context of environmental risk factors like chronic viral hepatitis, diabetes and alcohol exposure, often associated to an increased risk of cirrhosis. Antiviral treatments that are effective to counteract hepatitis B and C may also attenuate the risk of tumor development. However, since hepatitis B-related carcinogenesis is promoted independently of the onset of cirrhosis, such antiviral treatments as nucleo(t)side analogs can promote regression of cirrhosis, prevent clinical decompensation and variceal bleeding but not HCC. This means that in successfully treated patients with cirrhosis, HCC is often the consequence of their extended survival. In hepatitis C patients, a sustained virological response to interferon-based therapies can reduce the rate of HCC development, even in patients with cirrhosis who experience histological regression of their liver disease. Future therapies aimed at this endpoint in at risk populations should take into consideration pretreatment patient stratification for host, viral and environmental risk factors. In this context the recent discovery of single nucleotide polymorphisms involved in the immune system function and tumorigenesis, might permit enrollment of populations of patients enriched with HCC risk factors for targeted chemopreventive therapies. This could finally pave the way to personalized algorithms, as already seen in the diagnosis and treatment schemes for chemoprevention.

主 题 词：Hepatocellular carcinoma Hepatitis C virus Peginterferon Hepatitis B virus Human immunodeficiency virus Nucleoside analogues Sustained virological response Single nucleotide polymorphisms 

学科分类：1002[医学-临床医学类] 100214[100214] 10[医学] 

核心收录：

D　O　I：10.3748/wjg.v19.i9.1359

馆 藏 号：203223627...