临床肝胆病杂志2026，Vol.42Issue(8)：1782-1789,8.DOI:10.12449/JCH260808
乙型肝炎病毒致肝细胞癌的关键机制及防控策略
Key mechanisms of hepatitis B virus-induced hepatocellular carcinoma and related prevention and control strategies
摘要
Abstract
Chronic hepatitis B virus(HBV)infection is a major cause of hepatocellular carcinoma(HCC),with a population-attributable fraction of 57.1%for HCC globally and 76.1%for HCC in China.Identifying the early molecular mechanisms of HBV-driven hepatocarcinogenesis can facilitate precise HCC prevention.Persistent HBV replication,HBV mutation,HBV integration,and the synergistic interplay among them are the main mechanisms of HBV-driven hepatocarcinogenesis.HBV replication activates and sustains a chronic hepatic inflammatory microenvironment,providing conditions for accumulation of viral mutations;under the conditions of chronic inflammation,inflammatory factors cause the imbalance between apolipoprotein B messenger RNA editing enzyme catalytic polypeptide-like 3B and uracil-DNA glycosylase,which promotes HBV mutations and human genomic mutations and enhances the carcinogenic effect of HBV mutations,and the inflammatory microenvironment can promote dedifferentiation of mutated cells and acquisition of stemness;HBV genome integration can cause"gate-keeper"mutations including telomerase reverse transcriptase(TERT)promoter mutation,thereby triggering chromosomal instability and epigenetic reprogramming.The three events of HBV replication,mutation,and integration work synergistically under the evolutionary principle of"variation-selection-adaptation"and jointly drive the development and progression of HCC.The high-risk HBV mutation profile,circulating HBV integration fragments,and the TERT promoter mutations can be used to guide precision HCC prevention via antiviral prophylaxis and assist in early screening and monitoring of postoperative recurrence,which provides a scientific basis for refining stratified prevention and control strategies against HCC.关键词
乙型肝炎病毒/癌,肝细胞/病理过程/疾病预防Key words
Hepatitis B Virus/Carcinoma,Hepatocellular/Pathologic Processes/Disease Prevention引用本文复制引用
谢璐泽,席雅璇,曹广文..乙型肝炎病毒致肝细胞癌的关键机制及防控策略[J].临床肝胆病杂志,2026,42(8):1782-1789,8.基金项目
国家科技重大专项(2023ZD0500100) （2023ZD0500100）
国家自然科学基金面上项目(82473715,82373671) National Science and Technology Major Project(2023ZD0500100) （82473715,82373671）
General Project of National Natural Science Foundation of China(82473715,82373671) （82473715,82373671）
