摘要
Abstract
Primary biliary cholangitis(PBC)is an autoimmune liver disease characterized by persistent inflammation and destruction of the intrahepatic small bile ducts.Patients with PBC are at significantly increased risk of developing hepatocellular carcinoma(HCC),although the exact mechanisms remain unclear.This review systematically outlines the latest research progress on the association between PBC and HCC,explores potential risk factors and possible biomarkers,and aims to provide new insights into the prevention and treatment of the progression from PBC to HCC.Currently,the major risk factors for PBC patients developing HCC include male gender,advanced age,type 2 diabetes,coexisting viral hepatitis,cirrhosis,and non-response to ursodeoxycholic acid(UDCA)therapy.Key molecular pathways,such as the transforming growth factor-β(TGF-β)signaling pathway,and pro-inflammatory cytokines like interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),play central roles in the progression from PBC to HCC.Changes in the liver microenvironment,DNA damage,and tumor immune escape mechanisms are also critical factors.In particular,the abnormal expression of immune checkpoints,such as programmed death-1(PD-1)and programmed death-ligand 1(PD-L1),offers a promising direction for future immunotherapy strategies.关键词
原发性胆汁性胆管炎/肝细胞癌/肝硬化/风险因素/生物标志物/免疫逃逸Key words
primary biliary cholangitis/hepatocellular carcinoma/liver cirrhosis/risk factors/biomarkers/immune escape
