多结节肝细胞癌的研究进展

Research advances in multifocal hepatocellular carcinoma

【提要】多结节肝细胞癌可分为多中心发生及肝内转移两种形式。源于基因组学、转录组学或蛋白质组学研究的不同诊断策略，不但可明确肝癌的克隆起源，而且有可能获得治愈肝癌的方法。本文对乙肝病毒（HBV）DNA整合、p53突变、染色体杂合性缺失、线粒体D—Loop区突变、蛋白质组学等判断肝癌起源的方法做一综述，以便了解各种方法的适用范围及进展。并根据文献总结不同起源模式的肝癌预后情况。目前认为与多中心发生肿瘤相比，肝内转移型肝癌预后更差。

Based on the pathogenetic occurrence of the tumor, multinodular hepatocellular carcinoma can be classified into muhicentric occurrence and intrahepatic metastasis. Diffe- rent diagnostic strategies from genomics, transcriptomics and proteomics can be used to define the clonal origin of tumors and provide advisable method to cure the disease. Pathomorphologi- cal test was ＂ gold standard＂ in cancer diagnosis at one time. Currently, from the respect of molecular diagnosis, including HBV DNA intergration, p53 mutation, selective X chromosome inactivation, loss of heteozygosity of chromosomal DNA, mtDNA-Loop, transcriptional sequence, and comparative pro- teomics, we could accurately differentiate the clonal origin of tumors. Intrahepatic metastasis was demonstrated with a high early recurrence rate and low survival rate comparing to the mul- ticentric occurrence from the review of the previous study.