中国实用外科杂志

中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (10): 809-811.

• 专题笔谈 • 上一篇    下一篇

肝癌术后复发发生机制及临床病理学意义

丛文铭，吴孟超   

  1. 第二军医大学东方肝胆外科医院，上海 200438
  • 出版日期:2012-10-01 发布日期:2012-09-28

  • Online:2012-10-01 Published:2012-09-28

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摘要：

采用分子病理学检测技术，可将术后复发性肝癌（RHCC）分为两种主要类型，一种为单中心（单克隆）起源，属于残留复发;另一种为多中心（多克隆）起源，属于新生肿瘤。后者又可以再分为6种分子亚型，两种克隆型RHCC常以不同模式组合存在。根据区域癌化假说，还存在“第2区域肿瘤”的发生途径，由此RHCC的类型和发生机制可能更为复杂。正确判断RHCC的克隆起源对于临床提高RHCC个体化治疗水平具有实际的指导意义。为此，应重视建立适用性分子克隆诊断技术，为临床探讨RHCC的分类诊断和治疗路径提供指导依据。

关键词: 复发性肝癌, 克隆起源, 分子病理学

Abstract:

Mechanism of recurrent hepatocellular carcinoma and clinicopathological significance        CONG Wen-ming, WU Meng-chao. Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China
Corresponding author: CONG Wen-ming, E-mail: wmcong@smmu.edu.cn
Abstract    Based on molecular pathology, recurrent HCC (RHCC) can be divided into two types: one is monocentric (monoclonal) origin presenting postoperative residual recurrence, and the other is multicentric (multiclonal) origin, meaning a second primary tumor, which can be further divided into six subtypes with concomitant clonal types. However, according to the field cancerization hypothesis, there also exists the possibility of the so called “second field tumor”, which leads to a more complex mechanism and patterns of RHCC. Because correct determination of the clonal origin of RHCC may have actual reference value for personalized therapy, more attention should be paid to establish molecular clonal techniques suitable for pathological lab and to explore the clinical pathway in the diagnosis and treatment of RHCC based on their clonal classifications.

Key words: recurrent hepatocellular carcinoma, clonal origin, molecular pathology