| 摘要: |
| 在我国, 乙肝病毒慢性感染是引发肝细胞癌的主要原因。抗病毒措施是乙型肝炎治疗的关键, 抗乙肝病毒治疗可以降低肝细胞肝癌的发生风险, 但具体机制尚不清楚。在慢性炎症致癌的过程中, 乙肝病毒在人体微环境的压力下, 会通过“变异-选择-适应”的方式进化出具有生存和致癌优势的突变体。因此, 抗乙肝病毒治疗阻滞这一进化过程的作用应是其预防肝细胞癌发生的关键, 而目前药物和治疗标准的局限性不能充分发挥抗病毒治疗阻滞进化的作用, 从而引起临床研究上的一些反常现象。从病毒致癌过程中进化发育的特点出发, 提高抗病毒治疗的特异性和合理性可以进一步完善癌症预防措施。 |
| 关键词: 乙型肝炎肝病毒 抗病毒药 肝细胞癌 进化 |
| DOI：10.3724/SP.J.1008.2014.01293 |
| 投稿时间：2014-09-23修订日期：2014-11-03 |
| 基金项目:国家重点基础研究发展计划(“973”计划, 2015CB554000). |
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| Anti-HBV treatment delays development and evolution of HCC |
| YANG Fan,LIU Wen-bin,CHEN Lei,TAN Xiao-jie,CAO Guang-wen* |
(Department of Epidemiology, Faculty of Tropical Medicine and Public Health, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Chronic infection of hepatitis B virus (HBV) is the main cause of hepatocellular carcinoma (HCC) in China. Anti-HBV treatment is the key to hepatitis B treatment, which can reduce the risk of HCC, but with unknown mechanism. During chronic inflammation, HBV can evolve into mutants with advantages for survival and carcinogenesis through "mutation-selection-adaption" under the stress of microenvironment in the organism. Therefore anti-HBV treatment to block the process of evolution is critical to prevent carcinogenesis. However, the current anti-HBV treatment may not give full play to cancer prevention due to the limitations of current antiviral agents and standard of treatment, which can partly explain some unexpected findings in clinical research. Based on the characteristics of the HBV-HCC evolution process, cancer prevention can be further improved by enhancing the specificity and rationality of antiviral treatment. |
| Key words: hepatitis B virus antiviral agents hepatocellular carcinoma evolution |
