2023—2025年中外肝细胞癌诊疗指南的系统比较与解读及临床实践启示

Systematic comparison and interpretation of international and Chinese guidelines for hepatocellular carcinoma (2023-2025) and their implications for clinical practice

摘要:

肝细胞癌（HCC）是全球高发的恶性肿瘤之一，病死率居高不下。近年来，随着靶向及免疫治疗药物不断获批以及多学科诊疗模式的不断完善，全球主要组织和机构相继更新了HCC诊疗指南。受流行病学特征、医疗资源及诊疗理念差异影响，不同国家和地区在HCC筛查、诊断、分期及治疗策略方面存在明显不同。本文系统比较并解读2023—2025年美国肝病研究学会、英国胃肠病学会、欧洲肝病研究学会、欧洲肿瘤内科学会及中国原发性肝癌诊疗指南的核心推荐内容，重点分析其在筛查、诊断、分期和治疗决策方面的异同，旨在为我国HCC规范化、个体化临床诊疗提供参考和借鉴。

Abstract:

Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide, with a poor prognosis and high mortality. In recent years, the approval of novel targeted agents and immunotherapies, together with the advancement of multidisciplinary management, has led to continuous updates of HCC clinical practice guidelines. Owing to differences in epidemiology, etiological factors, and clinical practice patterns, substantial variations exist among guidelines regarding HCC screening, diagnosis, staging, and treatment. This review systematically compares and interprets the recommendations of major guidelines released between 2023 and 2025, including those from the American Association for the Study of Liver Diseases, the British Society of Gastroenterology, the European Association for the Study of the Liver, the European Society for Medical Oncology, and the Chinese Guidelines for the Diagnosis and Treatment of Primary Liver Cancer. By highlighting their similarities and differences, this article aims to provide practical insights for optimizing HCC management in China.