从《原发性肝癌诊疗指南(2024年版)》更新看我国肝癌综合治疗新进展OA北大核心CSTPCD
New advances in comprehensive treatment of liver cancer in China:Insights from the Guideline for diagnosis and treatment of hepatocellular carcinoma(2024 edition)
《原发性肝癌诊疗指南(2024年版)》的发布标志着我国肝癌综合治疗的新进展.指南在诊断、分期及治疗方面进行了重要更新,体现了近年来国内外肝癌研究的最新成果.诊断方面,增加了亚厘米肝癌的定义及相应的影像学标准,并对超声造影技术的应用提出了更高要求,同时更新了病理学诊断规范,特别是对肝细胞癌和肝内胆管癌的定义及分子病理检测进行了详细说明.分期方面,指南延续了中国肝癌分期(CNLC)系统,强调肿瘤学因素与病人全身情况的结合,同时提供了更为个性化的治疗建议.治疗选择方面,指南更新了 CNLC Ⅲa期的治疗路径,推荐经动脉化疗栓塞(TACE)/TACE联合系统抗肿瘤治疗,反映了联合治疗的趋势.手术治疗中,强调术后随访的重要性,并介绍了围手术期治疗及转化治疗的进展.系统治疗领域,新增了多种联合治疗方案,显示出优于传统单药治疗的效果.此外,指南进一步强调了多学科综合治疗协作组(MDT)的作用,建议各级医院通过MDT模式制定个体化治疗方案,以提高病人的生存率.新指南的发布将有助于规范我国肝癌的诊疗,提高整体治疗效果,并为"健康中国2030"规划目标的实现提供支持.
The release of the 2024 edition of the Guidelines for the Diagnosis and Treatment of Primary Liver Cancer marks a significant advancement in the comprehensive treatment of hepatocellular carcinoma(HCC)in China.The guidelines have been substantially updated in the areas of diagnosis,staging,and treatment,reflecting the latest research findings both domestically and internationally.In terms of diagnosis,the guidelines have introduced the definition of subcentimeter hepatocellular carcinoma and corresponding imaging standards,along with higher requirements for the application of contrast-enhanced ultrasound technology.Additionally,the guidelines have updated pathological diagnosis standards,particularly clarifying the definitions of hepatocellular carcinoma and intrahepatic cholangiocarcinoma,and provided detailed guidance on molecular pathology testing.For staging,the guidelines maintain the CNLC staging systems and emphasize the integration of oncological factors with the patient's overall condition,offering more personalized treatment recommendations.In treatment selection,the guidelines have updated the treatment pathway for CNLC stage Ⅲ a,recommending TACE or TACE combined with systemic therapy and highlighting the trend towards combined treatments.In surgical treatment,the guidelines stress the importance of postoperative follow-up and introduce the progress of perioperative treatment and conversion therapy.In the field of systemic therapy,several new combination treatment regimens have been introduced,demonstrating superior efficacy compared to traditional monotherapy.Furthermore,the guidelines underscore the role of multidisciplinary treatment teams(MDT)and recommend that hospitals at all levels implement MDT models to develop individualized treatment plans to improve patient survival.The release of the new guidelines will contribute to the standardization of liver cancer diagnosis and treatment in China,enhance overall treatment outcomes,and support the achievement of the"Healthy China 2030"initiative goals.
樊嘉;王征
复旦大学附属中山医院肝肿瘤外科复旦大学肝癌研究所,上海 200032
临床医学
原发性肝癌诊疗指南综合治疗多学科综合治疗协作组系统治疗影像学诊断病理学检测新辅助治疗
primary liver cancerclinical guidelinescomprehensive treatmentmultidisciplinary teamsystemic therapyimaging diagnosispathological examinationneoadjuvant therapy
《中国实用外科杂志》 2024 (009)
984-987 / 4
国家自然科学基金重大项目(No.82394450)
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