通讯作者: 陈惠怡, emailchy@126.com

DOI：10.12201/bmr.202512.00013

Recent Advances in Precision-Based Early Screening for Hepatocellular Carcinoma

• 摘要：肝细胞癌(Hepatocellular Carcinoma, HCC)作为全球第四大癌症致死病因,其早期诊断是改善预后的关键。相关专业协会推荐对患有慢性肝病的HCC高危人群进行差异化筛查,但当前策略面临多重挑战。传统HCC筛查测试灵敏度不足导致早期HCC漏诊率居高不下,高危人群从病毒性肝病向代谢性肝病扩展,筛查需求激增而既往指标效能衰减。本文聚焦肝癌早筛精准化研究,详细阐述新兴生物标志物和液体活检技术在无创生物标志物方面的应用,探索综合运用多种检测指标实施个性化精准筛查策略,以及面对当前社会高危人群范围从病毒性向代谢性肝脏疾病转变导致筛查范围急剧增大、既往检测指标失效问题探讨综合筛查策略与风险分层在筛查中的效能。提示未来研究应着重于新技术临床验证、精准化筛查方案开发、经济性分析以及多学科合作,改善未来HCC预后,减轻社会医疗负担。

  关键词： 肝癌; 肝硬化; 高危人群; 早期筛查; 精准化

   

  Abstract: Hepatocellular carcinoma (HCC), as the fourth leading cause of cancer-related mortality globally, highlights that early diagnosis is pivotal for improving prognosis. Relevant professional associations recommend differentiated screening for high-risk populations with chronic liver diseases, yet current strategies confront multiple challenges. The insufficient sensitivity of traditional HCC screening tests leads to persistently high missed diagnosis rates for early-stage HCC. Concurrently, the high-risk population is expanding from viral liver diseases to metabolic liver diseases, triggering a surge in screening demands and the attenuation of efficacy of previous indicators. This article focuses on precision research for early HCC screening, elaborating in detail on the applications of emerging biomarkers and liquid biopsy technologies in non-invasive biomarkers. It explores the implementation of personalized precision screening strategies by comprehensively integrating multiple detection indicators, and discusses the efficacy of comprehensive screening strategies and risk stratification in addressing the issues of drastically expanded screening scope (due to the shift of high-risk populations from viral to metabolic liver diseases) and the inadequate effectiveness of previous detection indicators. It is proposed that future research should prioritize clinical validation of new technologies, development of precision screening protocols, economic analysis, and multidisciplinary collaboration to improve future HCC prognosis and alleviate the social medical burden.

  Key words: Hepatocellular Carcinoma; Cirrhosis; High-Risk Population; Early Surveillance; Risk-Stratified Precision Surveillance

  提交时间：2025-12-04

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• 序号	提交日期	编号	操作
  1	2025-09-15	10.12201/bmr.202512.00013V1	下载

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