放射影像在肝细胞癌精准诊疗中的应用研究进展与展望

Research progress and prospects of the application of radiographic imaging in the precise diagnosis and treatment of hepatocellular carcinoma

肝细胞癌(HCC)是一种高度异质性的恶性肿瘤,复发率高,五年生存率低,已成为我国主要的公共卫生问题。HCC是目前唯一无需术前病理证实、依靠流行病史和典型影像征象即可确诊的实体肿瘤。近年来,在精准医学背景下,HCC的影像学诊断经历了从解到功能、从宏观到微观、从诊断到预测的范式转变,使得从定性、定量化的影像学角度研究HCC基因及其代谢规律等微观过程成为可能,为阐明HCC的发生发展及其临床治疗决策提供了更加精准的生物学和影像学信息。现回顾近年来肝癌影像学研究进展,展现影像学日新月异的横向发展及其在HCC精准诊疗中的纵向随访中的巨大潜力,同时也提出了当前肝癌影像学研究的不足,展望未来发展方向,以期更精准地用于HCC临床决策支持系统。

Hepatocellular carcinoma(HCC)is a highly heterogeneous kind of malignant tumor with a high recurrence rate and low five-year survival rate,which has become one of the major public health issues in China.Currently,HCC is the only solid tumor that can be solely diagnosed based on epidemiological history and typical imaging features without preoperative pathological confirmation.The paradigm for HCC imaging diagnosis has shifted in recent years from anatomy to function,from macroscopic to microscopic,and from diagnosis to prediction in the context of precision medicine,making it possible to study the microscopic processes such as HCC genes and their metabolic laws from the perspective of qualitative and quantitative imaging,thereby providing more accurate biological and imaging information for elucidating the occurrence,development,and clinical treatment decisions of HCC.This paper reviews the research progress of HCC imaging in recent years,demonstrating the rapid horizontal development and enormous potential of imaging in the vertical follow-up of HCC precision diagnosis and treatment.Simultaneously,it also puts forward the shortcomings of current HCC imaging research and looks forward to future development directions in order to be more accurately used in clinical decision support systems.