肝再生与肝转移肿瘤术后复发关系研究的现状

目的：探讨肝再生过程如何促进转移肿瘤的复发及相关机制，阐述肝再生的临床重要性及分子机制。方法：应用Mediine及PubMed期刊全文数据库检索系统，以“肝再生，肝转移瘤，肝切除术，肿瘤复发”等为检索词，检索2007—01—2012-03的相关文献，共检索到英文文献365条。纳入标准：1）肝部分切除术后肝脏再生；2）肝转移瘤复发；3）肝转移瘤术后与肿瘤复发的关系，符合分析的文献50篇。结果：肝脏再生是一个涉及多种效应细胞增殖反应和多种细胞因子表达调控的精密过程。这些因子如肝细胞生长因子（HGF），转化生长因子一β（TGF—β）和基质金属蛋白酶（MMPs）不仅能促进肝再生，也能促使肝转移肿瘤的复发。休眠期微转移瘤的激活和循环癌细胞在肝内的集聚被认为是肝转移肿瘤术后复发的相关机制，此机制尚未完全了解。结论：肝再生能促使肝转移肿瘤术后复发。尽管过去10年，相关肿瘤复发机制的研究有明显的进步，但是关于肝再生及其对肝部分切除术（PHx）后肿瘤复发的许多疑问，有待于进一步解决。

Liver regeneration impact on post-hepatectomy metastatic tumour recurrence

OBJECTIVE： To describes the responsible molecular pathways and the clinical importance of post-hepa- tectomy liver regeneration and investigates how the regenerative process promote metastatic tumour recurrence. METH- ODS： A total of 365 English papers were searched with liver regeneration, liver metastases, hepatectomy and tumor re- currence as search terms in Medline and PubMed databases from Jan, 2007 to Mar, 2012. Fifty papers were selected ac- cording to the standards as follows： 1）post-hepatectomy liver regeneration 2） the recurrence of liver metastasis; 3） the relationship between post-hepatectomy live regeneration and the recurrence of liver metastasis. RESULTS： The regenera- tive process that occurs postoperatively is a complex phenomenon. Some molecules such as hepatocyte growth factor, tumour growth factor beta and matrix metalloproteinases promote tumour growth and may contribute to the recurrence of liver metastasis. The reactivation of dormant micrometastases or the intrahepatic accumulation of circulating malignant cells have been suggested as the responsible mechanism, although not clearly described. CONCLUSIONS： Post-hepatecto- my liver regeneration can promote the recurrence of liver metastasis. Despite the considerable progress of the last decade, multiple queries remain to be clarified concerning liver regeneration.