原发性肝癌诊疗指南（2026年版）

Guidelines for the diagnosis and treatment of primary liver cancer (2026 edition)

摘要:

《原发性肝癌诊疗指南（2026年版）》于2026年4月正式发布，是我国肝癌防治领域最新的权威技术文件。新版指南在系统整合国内外高质量循证医学证据的基础上，尤其吸纳了多项由中国学者主导的原创研究成果，体现了我国肝癌临床研究水平的持续提升。与既往版本相比，2026年版指南首次将“预防、筛查和监测”独立成章，系统阐述肝癌一级预防与中、高风险人群管理策略，标志着我国肝癌防治模式由“以治疗为中心”向“预防—筛查—诊断—治疗”全周期管理的重要转变。在治疗策略方面，新版指南进一步强化以手术切除为目标的综合治疗理念，明确转化治疗和新辅助治疗在提高根治性切除率中的关键作用；在介入治疗领域，首次将肝动脉灌注化疗（HAIC）和选择性内放射治疗（SIRT）提升为独立推荐方案，与经动脉化疗栓塞（TACE）共同构建更加多元、精准的治疗体系。同时，指南强调抗病毒治疗、保肝及对症支持治疗在肝癌全程管理中的基础性地位，推动抗肿瘤治疗与肝功能维护及整体状况管理并重。作为我国肝癌防治的“国家方案”，新版指南的发布与实施将为规范化、精准化和个体化诊疗提供重要支撑，对提升肝癌早诊率、改善患者长期生存和生活质量具有重要意义，也将以中国证据和中国经验为全球肝癌诊疗贡献更具影响力的方案。

Abstract:

The Guidelines for the diagnosis and treatment of primary liver cancer (2026 edition) were officially finalized and released in April 2026, representing the most up-to-date national guidance for liver cancer management in China. The new edition systematically integrates recent high-quality evidence from both domestic and international studies, with particular emphasis on original research led by Chinese investigators and published in leading international journals, reflecting the growing global impact of China's liver cancer research. A major update of the 2026 guidelines is the establishment of "prevention, screening, and surveillance" as an independent chapter for the first time, providing a comprehensive framework for primary prevention and risk management in high- and moderate-risk populations. This structural innovation signifies a paradigm shift from a treatment-centered approach toward a full-spectrum continuum of care encompassing prevention, early detection, diagnosis, and treatment. In therapeutic strategies, the Guidelines further emphasize comprehensive treatment aimed at surgical resection, formally recognizing the roles of conversion therapy and neoadjuvant therapy in improving resectability and curative outcomes. In the field of interventional oncology, hepatic arterial infusion chemotherapy (HAIC) and selective internal radiation therapy (SIRT) are, for the first time, recommended as independent treatment options, together with transarterial chemoembolization (TACE), forming a more diversified and precise treatment landscape. In addition, the Guidelines underscore the integration of antiviral therapy, hepatoprotective measures, and supportive care into the overall management strategy, highlighting the importance of balancing tumor control with preservation of liver function and overall patient health. As a national consensus-based framework, the 2026 guidelines are expected to play a pivotal role in advancing standardized, precise, and individualized liver cancer care in China. Their implementation will contribute to earlier diagnosis, improved long-term survival, and better quality of life for patients, while also offering China's evidence-based experience and insights to the global liver cancer community.