原发性肝癌伴癌综合征的临床类型及相关机制的研究进展

Primary hepatic carcinoma with paraneoplastic syndrome: research progresses on clinical types and their basic mechanisms

原发性肝癌起病隐匿,确诊时多已进入晚期,预后差。伴癌综合征是指因肿瘤代谢物(如异位激素)或异常免疫反应(如交叉反应)等原因间接引起,不能用肿瘤原发病灶、直接蔓延或远处转移解释的某些内分泌、循环、免疫及神经系统的异常临床表现。高胆固醇血症、高钙血症、低血糖症等是目前肝癌患者常见的伴癌综合征。正确认识伴癌综合征对原发性肝癌患者的早期诊断与治疗有重要意义。本文就原发性肝癌伴癌综合征的临床类型及相关机制做一总结。

The onset of primary hepatic carcinoma(PHC)is usually occult,and early symptoms are not obvious.Most patients are at advanced stages of disease at diagnosis,and the prognosis is poor.Paraneoplastic syndrome(PNS)refers to the clinical manifestations indirectly caused by tumor metabolites or abnormal immune reactions that cannot be explained by the primary lesion,local tumor spread or distant metastasis.Hypercholesterolemia,hypercalcemia and hypoglycemia are the most commonly seen clinical presentations of PNS in PHC patients.Adequate understanding of PNS is of great importance in early diagnosis and treatment of PHC.In this review,we summarized the clinical manifestations and prognostic mechanisms of PNS in patients with PHC.