诊断学理论与实践2024，Vol.23Issue(1)：9-15,7.DOI:10.16150/j.1671-2870.2024.01.002
我国原发性肝癌筛查的现状、挑战及发展方向
Current status,challenges and future directions for hepatocellular carcinoma surveillance in China
摘要
Abstract
In 2020,primary liver cancer ranked as the sixth most common malignancy worldwide,with 905 700 newly-diagnosed cases,and 830 000 deaths with an overall mortality rate of 8.7/100 000,ranking third in in malignant tu-mors.In Asia,there were 657 000 newly-diagnosed cases and 609 000 deaths,accounting for 72.5%and 73.3%of the global burden,respectively.In China,primary liver cancer is one of the most common malignant tumors,with 410 000 new cases,and 391000 deaths with a mortality rate of 17.2/100 000,ranking the second highest among the causes of cancer deaths.Approximately half of annual global newly-diagnosed cases and deaths of liver cancer occurred in China,leading to an extremely heavy disease burden.Hepatocellular carcinoma(HCC)accounts for 75%-85%of primary liver cancer.The 5-year survival rate of HCC patients is merely 14.1%in China,mainly due to advanced disease stage at the diagnosis in most HCC patients.The low rate of diagnosis of early-stage HCC is one of the most important reasons for the poor treatment out-come of HCC patients.The key to improving the diagnosis of early-stage HCC lies on the effective HCC surveillance.The current surveillance method of"abdominal ultrasound+alpha-fetoprotein"is far from meeting the clinical needs in detect-ing early-stage HCC,which is faced with many problems,including low implementation rates of HCC screening,poor sensi-tivity for early-stage HCC,and new challenges posed by profound changes in the underlying etiologies of hepatocellular car-cinoma in the past decade.In order to optimize the efficacy of HCC surveillance and improve the prognosis of HCC pa-tients,we must adopt effective strategies,raise the implementation rate of HCC surveillance from the perspectives of pa-tients and healthcare professionals,develope new HCC surveillance tools of higher accuracy and with more convenience,[GALAD(gender,age,AFP-L3,DCP,AFP)score and liquid biopsy];advocating"individualized"surveillance strategies,stratified enrichment and precise screening to maximize the cost-effectiveness of healthcare resources.As one innovative model for individualized HCC surveillance,"artificial intelligence"in closed-loop precise liver disease management may serve as a strategic choice for disease management in China.关键词
肝癌/筛查/早期诊断/挑战/应对策略Key words
Hepatocellular carcinoma/Surveillance/Early detection/Challenges/Coping strategies分类
医药卫生引用本文复制引用
姜绍文,周惠娟,谢青..我国原发性肝癌筛查的现状、挑战及发展方向[J].诊断学理论与实践,2024,23(1):9-15,7.基金项目
国家自然科学基金青年项目(82070604,82270618) （82070604,82270618）
上海市临床重点专科(感染病学)(shslczdzk01103) （感染病学）
