Tumour evolution in hepatocellular carcinoma.,Nature Reviews Gastroenterology & Hepatology

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Tumour evolution in hepatocellular carcinoma.
Nature Reviews Gastroenterology & Hepatology ( IF 45.9 ) Pub Date : 2019-12-02 , DOI: 10.1038/s41575-019-0229-4
Amanda J Craig ₁ , Johann von Felden _{1,

2} , Teresa Garcia-Lezana ₁ , Samantha Sarcognato _{1,

3} , Augusto Villanueva _{1,

4}

Affiliation

Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, typically develops on the background of chronic liver disease and is an aggressive disease with dismal prognosis. Studies using next-generation sequencing of multiple regions of the same tumour nodule suggest different patterns of HCC evolution and confirm the high molecular heterogeneity in a subset of patients. Different hypotheses have been proposed to explain tumour evolution, including clonal selection or neutral and punctuated acquisition of genetic alterations. In parallel, data indicate a fundamental contribution of nonmalignant cells of the tumour microenvironment to cancer clonal evolution. Delineating these dynamics is crucial to improve the treatment of patients with HCC, and particularly to help understand how HCC evolution drives resistance to systemic therapies. A number of new minimally invasive techniques, such as liquid biopsies, could help track cancer evolution in HCC. These tools might improve our understanding of how systemic therapies affect tumour clonal composition and could facilitate implementation of real-time molecular monitoring of patients with HCC.

中文翻译：

肝细胞癌中的肿瘤演变。

肝细胞癌（HCC）是原发性肝癌的最常见形式，通常在慢性肝病的背景下发展，是一种侵袭性疾病，预后不良。使用下一代测序对同一肿瘤结节多个区域进行的研究表明，HCC进化的模式不同，并证实了部分患者体内的高分子异质性。已经提出了不同的假设来解释肿瘤的进化，包括克隆选择或遗传改变的中性和标点采集。同时，数据表明肿瘤微环境的非恶性细胞对癌症克隆进化的根本贡献。描述这些动态对改善HCC患者的治疗至关重要，特别是有助于了解HCC的进化如何驱动对全身疗法的抵抗力。许多新的微创技术，例如液体活检，可以帮助追踪HCC中的癌症进展。这些工具可能会增进我们对全身疗法如何影响肿瘤克隆组成的了解，并可能促进对HCC患者进行实时分子监测。

更新日期：2019-12-02

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