文章：

肝癌预防的转化策略

Translational strategies for cancer prevention in liver

原文发布日期：2003-05-01

DOI: 10.1038/nrc1076

类型: Review Article

开放获取: 否

要点：

1. Liver cancer is the third most deadly cancer worldwide and is ranked fifth in terms of the number of cases.
2. Carcinogenic toxins produced by moulds (aflatoxins) interact synergistically with infection with hepatitis B virus (HBV) to amplify the risk of hepatocellular carcinoma (HCC) in humans — particularly in the developing world, where most of the disease burden lies.
3. Molecular-progression pathways have been difficult to elucidate for HCC. However, several genetic and epigenetic changes in targets that affect the fate and actions of the viral and chemical aetiological agents offer promise as aids for early diagnosis.
4. Primary prevention of HCC, in the form of universal vaccination programmes against HBV in newborns, is proving effective, but it remains beyond the reach of many at-risk populations.
5. Secondary prevention of HCC, in the form of chemoprevention directed at many targets, offers potential benefits. Early-stage interventions designed to intercept and enhance the detoxification of aflatoxins, and later-stage interventions to inhibit or reverse cirrhosis or block the occurrence of second primary HCCs, are important opportunities for clinical-trial development.

要点翻译：

1. 肝癌是全球致死率排名第三的癌症，其发病率位居第五。
2. 霉菌产生的致癌毒素（黄曲霉毒素）与乙型肝炎病毒（HBV）感染具有协同作用，会显著增加人类罹患肝细胞癌（HCC）的风险——这一现象在承担主要疾病负担的发展中国家尤为突出。
3. 肝细胞癌的分子进展通路至今难以阐明。然而，针对病毒和化学病因作用靶点的若干遗传学和表观遗传学改变，为早期诊断提供了潜在辅助手段。
4. 通过新生儿普遍接种乙肝疫苗进行肝细胞癌的一级预防已被证实有效，但许多高危人群仍未能获得此项保护。
5. 采取多靶点化学预防措施的二级预防则展现出潜在效益。早期干预措施旨在阻断并促进黄曲霉毒素解毒，后期干预则侧重于抑制或逆转肝硬化、阻断第二原发肝癌发生，这些均为临床试验发展提供了重要机遇。

英文摘要：

Unlike many other types of human cancer, the aetiology of liver cancer is well understood. Infection with hepatitis viruses, coupled with dietary exposure to the fungal toxin aflatoxin, increases the risk of the disease. Although primary prevention, based on vaccination and avoiding exposure to these agents, is an appealing option, such strategies will require considerable investment of time and resources to be successful. In the developing world — where the burden of liver cancer is highest — immediate, practical and economical approaches are essential. So, targeted chemoprevention might be most appropriate for the present generation of individuals at risk.

摘要翻译： 

与其他许多人类癌症不同，肝癌的病因已十分明确。肝炎病毒感染，加上饮食中接触真菌毒素黄曲霉毒素，会增加患病风险。尽管通过接种疫苗和避免接触这些致病因素来进行初级预防颇具吸引力，但这些策略需要投入大量时间和资源才能奏效。在肝癌负担最沉重的发展中国家，更需要立即可行且经济实惠的方法。因此，对于当前这一代的易感人群而言，靶向化学预防可能最为适宜。

原文链接：

Translational strategies for cancer prevention in liver