提高肝癌肝移植疗效的策略

Strategies to improve the efficacy of liver transplantation for hepatocellular carcinoma

原发性肝癌的发病率和死亡率居我国恶性肿瘤的第2位，肝移植是治疗肝癌的重要手段之一[1]。肝癌患者占我国每年肝移植受者总数的40％～50％。随着肝移植手术技术的成熟和术后管理水平的提高，术后非肿瘤因素导致的死亡率已显著下降，而术后肿瘤复发成为影响疗效的主要因素。如何有效防治肝移植术后肿瘤复发对提高疗效有重大意义。

Hepatocellular carcinoma （HCC） is a major cause of cancer mortality worldwide, and liver transplantation （LT） has the potential to improve the survival for patients with HCC. However, tumor recurrence after LT remains the main obstacles for long-term survival. Selection of the ideal recipients based on Milan criteria or Shanghai Fudan criteria is a key point to reduce the incidence of recurrence. Genomics and proteomics combined with tumor specific tumor markers detection are helpful to screen out the recipients. The norms of tumor-free operation should be strictly followed intraoperatively. Preventive chemotherapy and evaluation of immune function should be considered postoperatively to reduce the risks of tumor recurrence and metastasis.