极早期肝癌的治疗现状

On State-of-art of Treatment of Very-early Stage Hepatocellular Carcinoma

极早期肝癌的治疗方法多样,各有所长。肝移植、手术切除、经皮消融是极早期肝癌最有效的治疗方法。由于供肝资源缺乏,肝移植难以广泛开展,手术切除和经皮消融在临床上最为常用,且效果理想。经皮消融作为新型治疗方式,在微小肝癌和老年患者的治疗中较手术切除有明显优势,但术后复发率较手术切除高。当以上3种治疗方法不可行时,肝动脉插管栓塞化疗可作为补救性治疗。局部联合治疗优于单独局部治疗,适用于无法手术切除的患者。"观察疗法"仍需更多的临床研究证实其安全性和有效性。

In the treatment of very-early stage hepatocellular carcinoma （ HCC）, several therapies have their own strengths. Liver transplantation, surgical resection, and percutaneous ablation are the most effective procedures for very-early stage HCC. Liver transplantation is difficult to carry out due to lack of donors. Surgical resection and percutaneous ablation are the most commonly used methods with ideal effects. Compared with surgical resection, percutaneous ablation has its obvious advantages in patients with small HCC and senile patients, but the recurrence rate is relatively high. When the above mentioned three methods are not feasible, transarterial chemoembolization is a remedial treatment. Combined use of local therapy is superior to topical therapy alone and suitable for patients with unresectable lesions. The ＂observing therapy＂ still needs more clinical studies to confirm its safety and effectiveness.