他汀类药物在肝细胞癌防治中的研究进展与争议

Advances and controversies of statins application in prevention and treatment of hepatocellular carcinoma

他汀类药物作为调脂药物已广泛应用于高脂血症的治疗和心脑血管疾病的一级和二级预防。肝细胞癌(HCC)预后不良,给患者造成严重的恶性肿瘤负担。他汀类药物可抗肿瘤增殖、降低HCC患病风险及术后复发风险、延长生存期、增强其他治疗手段的疗效,因此可能会增加HCC患者的临床获益。他汀类药物可影响MARK/ERK信号通路的表达,促使恶性细胞凋亡,可以降低乙型肝炎病毒感染者HCC的发生风险。他汀类药物不仅对HCC具有预防作用,而且对不同疾病阶段的HCC具有一定的治疗作用,尽管其并不能替代当前手术、消融、分子靶向治疗和免疫疗法等治疗手段,但作为辅助用药,他汀类药物为HCC患者带来的临床获益仍具有重要意义。他汀类药物在HCC防治中的进展逐渐受到关注,但对其最终能否成为HCC防治的辅助用药,目前仍存在诸多讨论与争议。文章通过对他汀类药物在HCC防治中研究新进展及现存争端进行总结及评述,以期对未来临床实践提供帮助。

Statins,as lipid-regulating drugs,have been widely used in the treatment for hyperlipidemia and the primary and secondary prevention of cardio-cerebrovascular diseases.Hepatocellular carcinoma(HCC)is a serious burden of liver disease in China with poor prognosis,thus effective adjuvant drug used for HCC treatment has attracted much attention.Statins can suppress tumor growth,decrease the risk of tumorigenesis and postoperative recurrence of HCC,extend the survival time and improve the therapeutic effect of other treatment,therefore might increase the benefit obtained by the HCC patients.Statins also can impact the expression of MAPK/ERK signaling pathway,promote the apoptosis of malignant cells and ameliorate the HCC risk of hepatitis B virus infected patients.Statins not only prevents the HCC,but also has part therapeutic effect on the different stage of HCC.Although it can′t replace the operation,radiofrequency ablation,molecular targeted treatment and immunotherapy currently,statins may be a potential adjuvant drug to provide clinical benefit for HCC patients.The advancement of statins application in the prevention and treatment of HCC has attracted more attention recently,however,discussion and controversy also existed about whether it can eventually become an adjuvant therapy for HCC.The purpose of this paper is to summarize and comment on the new development and disputes of statins application in the prevention and treatment of HCC in recent years,to provide help for the future clinical practice.