肝细胞性肝癌骨转移的诊疗进展与预后因素研究

随着临床诊治水平的不断进步，肝细胞性肝癌（hepatocellular carcinoma，HCC）患者的总生存时间获得延长，但是HCC骨转移发生率则显著升高，HCC骨转移的筛查与诊治已成为全球性热点与难点问题。明确HCC骨转移的致病机制有助于临床肿瘤筛查及诊疗手段的提高，血管形成和上皮-间质转化（epithelial mesenchymal transition，EMT）是HCC骨转移的主要致病机制，骨微环境使得HCC骨转移持续发生。明确HCC骨转移的预后因素有利于对此类患者进行早期干预以延长患者总生存期，但目前尚未就HCC骨转移患者的治疗策略达成共识。本文就HCC骨转移分子病理学致病机制的研究进展进行综述，为早期筛查、精准诊断和个体化治疗提供依据。 

Bone metastases from hepatocellular carcinoma: clinical features and prognostic factors

Progressive improvements in diagnostic modalities and therapeutic procedures have improved the survival of patients with hepatocellular carcinoma (HCC). However, the incidence of bone metastases in HCC is increasing, and early diagnosis and the development of effective treatment strategies remain global challenges. Thus, it is important to reveal the mechanism of metastasis from HCC to improve the screening and treatment of metastatic disease. Just like other osteotropic cancers, angiogenesis and epithelial-mesenchymal transition play a vital role in bone colonization. Simultaneously, the bone microenvironment enters a vicious circle that can increase bone destruction. To date, prognostic factors and treatment strategies remain unclear for patients with HCC and bone metastases. Future molecular pathological studies will provide further clues as to early diagnosis and individual treatment.