tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2017-2-68-75tumors-345Research ArticleОБЗОРЫ И АНАЛИТИКАREVIEWS AND ANALYSISПроблема современных классификаций гепатоцеллюлярного рака. АналитическийThe problem of current classications of the hepatocellular carcinoma. Analytical reviewРотинД. Л.RotinD. L.

д.м.н., заведующий патологоанатомическим отделением

MD, PhD, DSc, Head of Pathology Department

danlerot@mail.ruМорозЕ. А.MorozE. A.

к.м.н., с.н.с. отдела патологической анатомии

MD, PhD, senior researcher

moroz-kate@yandex.ruГБУЗ «Московский клинический научно-практический центр имени А.С. Логинова» (ГБУЗ МКНЦ ДЗМ), МоскваРоссияMoscow Clinical Scientific Center, MoscowRussian FederationФГБУ «Российский онкологический научный центр им. Н. Н. Блохина» (РОНЦ им. Н. Н. Блохина), МоскваРоссияN. N. Blokhin Russian Cancer Research Center, MoscowRussian Federation201720072017026875Copyright © Ротин Д.Л., Мороз Е.А., 20172017Ротин Д.Л., Мороз Е.А.Rotin D.L., Moroz E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/345

Гепатоцеллюлярный рак (ГЦР) в подавляющем большинстве случаев развивается на фоне хронических заболеваний печени, чаще – вирусных гепатитов В и С, и часто диагностируется на поздних стадиях [1, 3]. Несмотря на некоторые успехи современной онкологии (некоторые пациенты «доживают» даже до метастазов ГЦР в головной мозг [1]), прогноз при ГЦР остается плохим. В целом прогноз зависит не только от биологических характеристик самой опухоли, но и от фонового заболевания печени, часто – на стадии цирроза. В отличие от другой злокачественной опухоли печени – холангиоцеллюлярной карциномы, для ГЦР нет универсальных прогностических классификаций [2]. Так, международная классификация TNM, используемая для большинства солидных опухолей, не может применяться в качестве «референсной» для ГЦР [4]. Для определения прогноза c последующей тактикой ведения в западных и азиатских странах в последние годы разработаны различные шкалы оценки и классификации ГЦР. Для создания таких систем чаще используют регрессионную модель на основании прогностических переменных изучаемой популяции. На сегодняшний день не существует универсальной и признанной всеми прогностической шкалы или классификации ГЦР. Почти все эти классификации включают в себя такие признаки, как: функция печени, характеристики опухоли, клинические проявления, сопутствующие заболевания, наличие цирроза [3]. 

Hepatocellular carcinoma (HCC) in vast majority of cases develops on the background of the chronic liver diseases, more often – viral hepatitis B and C, and is diagnosed at the advanced stages [1, 3]. Despite the advantages of the modern oncology (some patients live till appearance of brain metastases [1]), prognosis in HCC is still poor. In general, prognosis depends on not only biological characteristics of the tumor itself, but also on the background of the liver condition, often – at the stage of the cirrhosis. As distinct from the other malignant tumor of liver – cholangiocellular carcinoma, there are no universal prognostic classifications for HCC [2]. International classification TNM used for majority of solid tumors is not appropriate to be ‘reference’ for HCC [4]. There are several prognostic scales and classifications created recently in West and Asian countries. For the creation of such systems they use more often the regression model on the basis of prognostic variables of the investigated population. Currently, there is no universal prognostic classification or scale for HCC ГЦР. Almost all these classifications included the features; liver function, tumor characteristics, clinical behavior, undercurrent diseases, presence of the cirrhosis [3]. 

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The authors declare that there are no conflicts of interest present.