HBV及HCV感染时的肝癌监测

HCC Surveillance for HBV and HCV
Kwang-Hyub Han
Yonsei University College of Medicine， Seoul， Korea

On the second day of APASL， Professor Kwang-Hyub Han gave a lecture on hepatocellular carcinoma (HCC) surveillance for patients with HBV and HCV infection. He said increasing evidences suggested that persistent HBV replication indicated as serum HBV DNA concentration was a predictor of HCC. Therefore， suppression of HBV replication by oral nucleotide analogue resulted in lower incidence of HCC.

    On the other hand， in patients with chronic hepatitis C， the incidence of HCC in cirrhotic patients is 2-8% per year， significantly higher than that in non-cirrhotic patients. Since advanced hepatic fibrosis is more correlated with HCC development， simple and non-invasive assessment of liver fibrosis is more important in surveillance， and a large scale study on these non-invasive methods is necessary.

At last， Professor Kwang-Hyub Han recommended that US and serum AFP measurement every 6 months shoud be the most appropriate method in the surveillance of HCC. However， because of the low sensitivity， alternative method or identification of a novel biomarker may be required.

在APSAL大会的第二天，Kwang-Hyub Han教授做了题为“Recommendation on the Surveillance Program for HBV and HCV”的大会报告。他指出持续的HBV病毒复制，即血清HBV病毒载量是原发性肝癌的一个预测因子，因此抗病毒治疗抑制HBV病毒复制可减低HCC的发生。而慢性丙型肝炎伴肝硬化患者HCC发生率高于非肝硬化患者，故肝纤维化进展程度的监测至关重要。Kwang-Hyub Han教授还建议每6个月行超声及AFP检测。