264 Infect Dis Info, Vol. 25, No. 5, October 30, 2012 2012 EASL-EORTC 2011 R735.7 A 1007-8134(2012)05-0264-05 Brief introduction to 2012 EASL-EORTC Clinical Practice Guidelines on the management of hepatocellular carcinoma QU Jian-hui, SU Shu-hui Liver Cancer Treatment and Research Center, 302 Hospital of PLA, Beijing 100039, China [Abstract] EASL-EORTC Clinical Practice Guidelines on the management of hepatocellular carcinoma () developed by European Association for the Study of the Liver and European Organisation for Research and Treatment of Cancer at the end of 2011 gives advice for the surveillance, diagnosis, staging system, molecular classification and therapeutic strategies for patients in order to provide practical guidence for physicians, patients, health -care providers and health -policy makers according to evidence -based medicine. [Key words] carcinoma, hepatocellular; guidebooks; therapeutics 2001 European Association 1.2.1 for the Study of the Liver, EASL 58%~89% 90% hepatocellular carcinoma, [1] 10 63% 1.2.2 2011 EASL European AFP γ- Organisation for Research and Treatment of Can- DCP AFP-L3 /AFP α- cer, EORTC AFU -3GPC3 AFP [2] [3] 1 DCP WHO AFP HCV 1.3 [4] 6 6 AFP - 37% 1.1 1 3~4 Child-Pugh A B C 1 cm 2 2HBV F3 1.4 1.2 2 cm 1
Infect Dis Info, Vol. 25, No. 5, October 30, 2012 <1 cm 1~2 cm >2 cm 4 4 CT/ 4 CT/ / 1 2 1 [3] 1 Figure 1 Diagnostic algorithm and recall policy for [3] [9] 2 CD34 CK19 EpCAM 2.1 2001 EASL 3 2 cm 2 EASL-EORTC 1 AFP 400 ng/ml Barcelona clinic liver cancer, BCLC 2005 2 EASL American Association for the Study of Liver Diseases, AASLD 2 cm 1 1~ 2 cm 2 CT BCLC 5 0 A B C D [7] AFP AASLD 1 CT N1 M1 Child-Pugh [8] 1~2 cm 1 Eastern Cooperative 10% 2 Oncology Group, ECOG [9] 2.2 ECOG GPC3 70HSP70 GPC3 LYVE1 survivin [10-11] BCLC B K19 Ep- BCLC A 2 CAM CD34 [12-14] GPC3 sorafenib 68%~72% 4 92% [11 15] 105 HSP70 GPC3 GS 10 72%100% 2 [11] 2 Wnt 2
266 Infect Dis Info, Vol. 25, No. 5, October 30, 2012 0 A~C D Child-Pugh A PST 0 Child-Pugh A~B PST 0~2 Child-Pugh C PST >2 0 A <2 cm 3 3 cm PST 0 B PST 0 N1 M1 PST 1~2 C D 3 3 cm / PEI/RF TACE 30%~40% OS>60 5 40%~70% 2 20% 40% 10% OS 20 14~45 OS 116~14 OS <3 PST. PEI. RFA. TACE. OS. BCLC (2011) [8] Figure 2 Updated BCLC staging system and treatment strategy (2011) [8] S1-TGF-beta S2-EpCAM 5 5.1 5.1.2 5.1.1 5 60%~80% [22] 2 cm 5 66% 5% 40% 5 2~5 cm 52%5 cm 37% [23] 30%~50% [16-17] 5 57% 3 26% 5 60% 5 2%~3% 10% [18-19] 50% 1980 15% 3%~5% 20 20% 2 cm 30%~60%2~ 80%~90% 10% [23] 5 cm 60%~90% 5 cm 5.1.3 5 70% 15 min 2 10 mmhg1 mmhg=0.133 kpa 5.2 5 cm portal vein embolization, PVE 3 cm [20-21] 20% 1% PVE [24]
Infect Dis Info, Vol. 25, No. 5, October 30, 2012 5 2 cm 90% 2~3 cm 70% 70% 15% 3~5 cm 50% 1 5 2 cm 3% 10% 30% PEI 20% 3 cm 43% 4 2 cm RFA PEI PEI Child- 5.2.1 Pugh A RFA 3~ AFP 5 cm 3 3 cm 200 ng/ml 15 ng/ml/ Child-Pugh B 2 T1 2 cm 3 cm 50% BCLC A RFA 5.2.2 ra- diofrequency ablation, RFA 5.4 transcather arterial chemoembolization, TACE [25-26] - T2 6 TACE 5.2.3 6.5 cm 2~3 4.5 cm 8 cm 5%~10% Child-Pugh A B7 7 3~4 2 1 TACE 5.2.4 living donor liver transplantation, LDLT 5%5.5 40% LDLT LDLT 6-7 LDLT LDLT 6.1 5.3 percutaneous ethanol injection, PEI [27]
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