gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1592Research ArticleЛЕКЦИИ И ОБЗОРЫLECTURES AND REVIEWSФакторы риска развития гепатоцеллюлярной карциномыRisk factors of development of hepatocellular carcinomaИвашкинВ. Т.IvashkinV. T.МорозоваМ. А.MorozovaM. A.МаевскаяМ. В.MayevskayaM. V.СоколинаИ. А.SokolinaI. A.ГерманЕ. Н.GermanYe. N.БундинаМ. В.BundinaM. V.Московская медицинская академия им. И.М. СеченоваRussian Federation200906022009191415Copyright © Ивашкин В.Т., Морозова М.А., Маевская М.В., Соколина И.А., Герман Е.Н., Бундина М.В., 20092009Ивашкин В.Т., Морозова М.А., Маевская М.В., Соколина И.А., Герман Е.Н., Бундина М.В.Ivashkin V.T., Morozova M.A., Mayevskaya M.V., Sokolina I.A., German Y.N., Bundina M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1592

Цель обзора. Обратить внимание практикующих врачей на факторы риска развития гепатоцеллюлярной карциномы (ГЦК), обозначить группу пациентов с высокой вероятностью развития данной опухоли, сформулировать алгоритм скрининга пациентов из группы риска.Основные положения. К независимым факторам риска развития ГЦК относят вирусы гепатитов В и С, уровень нагрузки вирусом гепатита В, стадию цирроза печени, мужской пол, возраст старше 40 лет, употребление алкоголя и курение. Пациентам из группы риска для своевременной диагностики ГЦК необходимо исследование уровня альфа­фетопротеина и выполнение УЗИ органов брюшной полости один раз в 6 мес; при обнаружении каких­либо образований печени показано дальнейшее углубленное обследование, включающее компьютерную и магнитно­резонансную томографию, прицельную биопсию образования.Заключение. По данным проводимых в настоящее время исследований, заболеваемость ГЦК в мире неуклонно возрастает. К больным из группы риска относятся курящие и употребляющие алкоголь пациенты мужского пола в возрасте старше 50 лет (для лиц белой расы) с циррозом печени, особенно вирусной этиологии. В качестве профилактики ГЦК необходимо рассматривать предупреждение инфицирования вирусами гепатитов В и С, устранение гепатотоксичных веществ, вакцинацию против гепатита В, проведение противовирусной терапии у больных гепатитами В и С. Пациентам из групп риска развития ГЦК необходимо регулярно (один раз в полгода) проводить скрининговые тесты для выявления опухоли. Обнаружение ее на ранних стадиях позволит вовремя начать лечебные мероприятия, что в результате поможет повысить выживаемость пациентов.

The aim of review

The aim of review. To draw attention of general practitioners to the risk factors of hepatocellular carcinoma (HCC) development, to define group of patients with high probability of development of this tumor, to outline algorithm of screening diagnostics for patients of high risk group.

Original positions of the report. Independent risk factors for HCC development include hepatitis B and C viruses, the level of hepatitis B viral load, the stage of liver cirrhosis, male gender, age over 40 years, alcohol intake and smoking. Patients of high risk group should undergo investigation of alpha-fetoprotein level and abdominal US once per 6 months for early diagnostics of HCC; at detection of any liver lesions further deep investigation including computer and magnetic-resonance tomography, guided biopsy of the lesion is indicated.

Conclusion

Conclusion. According to present studies data, morbidity of HCC all over the world steadily grows. High risk group for HCC include patients of male gender over 50 years old (for Caucasian patients) with liver cirrhosis, especially of viral etiology, smoking and consuming alcohol. Prophylaxis of HCC should include prevention of hepatites B and C viruses infection, elimination of hepatotoxic substances, hepatitis B virus vaccination, antiviral therapy for patients with hepatites B and С. Patients from HCC risk groups need to be screened for tumor regularly (once in half a year). Its detection at the early stage allows to start medical actions in time, that helps to increase patients’ survival rate.

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The authors declare that there are no conflicts of interest present.