肝癌的診斷及治療最新發展

The Diagnosis and Treatment Strategy of Hepatocellular Carcinoma

劉鐘軒(Chung-Hsien Liu) ； 蔡正中(Cheng-Chung Tsai) ； 陳海雄(Hai-Hsiung Chen)

《內科學誌》 24卷2期 (2013/04) Pp. 85-94

https://doi.org/10.6314/JIMT.2013.24(2).02

摘要

根據行政院衛生署的統計資料顯示，肝癌是台灣癌症死亡的第二大原因，每年約有7,000名患者死於肝癌。主要的原因是B型肝炎及C型肝炎的高盛行率，使慢性肝病得以進一步發展成肝硬化及肝癌。早期肝癌且沒有肝硬化的患者手術切除是首選治療，對於有肝硬化的肝癌患者，原位肝臟移植則是治療肝癌的最好方法且腫瘤復發的風險最低。若患者的肝癌不能手術切除或不具移植資格，則需要選擇替代療法：包括局部灼燒術、肝動脈栓塞化療及放射性栓塞、分子標靶治療。治療上面臨各種挑戰，最有效的方法仍為預防。有效的臨床照顧需要在固定的時間內追蹤病人，肝癌治療小組針對病人的個別性擬定完整的治療計劃來早期診斷出肝癌。

關鍵字

肝炎 ； 肝硬化 ； 肝癌

並列摘要

The incidence of hepatocellular carcinoma is highest in Asia and Africa, where the endemic high prevalence of hepatitis B and hepatitis C strongly predisposes to the development of chronic liver disease and subsequent development of hepatocellular carcinoma. Hepatocellular carcinoma is the second leading cause of cancer deaths in Taiwan, with over 7,000 people affected. Hepatocellular carcinoma is now increasingly recognized at a much earlier stage as a consequence of the routine screening of patients with known cirrhosis, using cross-sectional imaging studies and serum alpha-fetoprotein measurements. Resection may benefit certain patients, albeit mostly transiently. Many patients are not candidates given the advanced stage of their cancer at diagnosis or their degree of liver disease could be cured by liver transplantation. Only a fraction of all patients undergo surgical intervention or have access to transplantation. In these patients, local ablative therapies, including radiofrequency ablation, chemoembolization, radioembolization and potentially novel chemotherapeutic agents, may extend life and provide palliation.

並列關鍵字

Hepatitis ； Liver cirrhosis ； Hepatocellular carcinoma