关键词: 肝细胞癌, 综合治疗, 病因学, 非酒精性脂肪性肝病, 病毒性肝炎

Abstract: The global incidence of liver cancer continues to rise significantly. The primary etiologies of liver cancer include hepatitis virus infections, non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, and aflatoxin exposure, all of which are closely associated with different types of liver disease backgrounds. The treatment strategies for hepatocellular carcinoma (HCC) are diverse, encompassing surgical treatment, local therapies, and systemic therapies, with surgical treatment playing a crucial role in the long-term survival of HCC patients. According to the Chinese guidelines for the diagnosis and treatment of primary liver cancer, the recommended treatment modalities include surgery, such as resection, local therapies represented by transarterial chemoembolization (TACE), and systemic treatments including targeted therapies and immunotherapies. Given that a significant proportion of HCC patients in China have a background of hepatitis B virus (HBV) infection and cirrhosis, with many tumors diagnosed at an advanced stage, treatment strategies primarily focus on surgery, supplemented by comprehensive treatment approaches to improve resection rates, reduce recurrence rates, and thereby enhance patient survival. Different etiologies and underlying liver disease significantly influence the comprehensive treatment strategies for HCC. Patients with HCC related to viral hepatitis often have concomitant cirrhosis, requiring careful management of liver function and postoperative antiviral therapy. Although patients with NAFLD-related HCC tend to have a longer postoperative survival period, they face higher surgical risks, and the efficacy of immunotherapy is generally less favorable compared to HCC of other etiologies. Additionally, for patients with HCC complicated by advanced cirrhosis or portal vein tumor thrombus, local and systemic treatment strategies need to be individualized based on the specific etiology and disease state. In the future, the treatment of HCC will evolve towards more precise and individualized approaches, integrating etiological factors and liver disease backgrounds to optimize treatment strategies, with the aim of achieving better therapeutic outcomes and long-term survival rates.

Key words: hepatocellular carcinoma, comprehensive treatment, etiology, non-alcoholic fatty liver disease, viral hepatitis