肝癌是全球癌症相关死亡的第三大原因,存在早期诊断困难、治疗选择受限及复发率高的问题。因此,深入研究肝癌的分子机制,发现新的治疗靶点和方法,对改善肝癌诊断和预后具有重要意义。Tribbles假激酶(TRIB1、TRIB2、TRIB3)因其在调节炎症、代谢和癌症中的独特作用已经成为研究热点。它们通过调控细胞周期在肝癌中起关键作用,并可能影响治疗抵抗性和免疫逃逸机制。文章总结近年来Tribbles假激酶家族在肝癌中作用机制的研究进展,旨在为肝癌的诊断、治疗和预后提供新的思路和策略。Liver cancer is the third leading cause of cancer-related deaths globally, characterized by difficulties in early diagnosis, limited treatment options, and high recurrence rates. Therefore, in-depth research on the molecular mechanisms of liver cancer to discover new therapeutic targets and methods is crucial for improving liver cancer diagnosis and prognosis. Tribbles pseudokinases (TRIB1, TRIB2, TRIB3) have become research hotspots due to their unique roles in regulating inflammation, metabolism, and cancer. They play a key role in liver cancer by regulating the cell cycle and may also influence treatment resistance and immune evasion mechanisms. This paper summarizes recent research progress on the mechanisms of the Tribbles pseudokinase family in liver cancer, aiming to provide new ideas and strategies for liver cancer diagnosis, treatment, and prognosis.
目的联合肝脏离断和门静脉结扎二步肝切除术(associating liver partition and portal vein ligation for staged hepatectomy,ALPPS)可以提高肝脏恶性肿瘤根治性切除率,但并发症的发生率和围手术期的病死率较高。本研究通过损伤控制原则下的ALPPS—期手术改进,系统评价该术式的安全性及有效性。方法通过病例的精准纳入、精确的剩余肝脏体积评估和一期手术规划以及微创技术的应用,对ALPPS—期手术进行损伤控制,统计分析手术指标、功能性剩余肝脏体积增生、术后并发症的发生率及总体生存率。结果空军特色医学中心联合北京天坛医院共计60例患者接受了损伤控制性一期改良式ALPPS手术,一期术后无严重并发症发生,手术时间(146.3±22.7)min,出血量(148.5±27.8)ml,剩余肝脏体积平均增加(179.3±72.4)cm3,与功能性剩余肝脏体积的增加差异无统计学意义。二期手术时间(287.5±48.2)min,出血量(615.7±62.4)ml,严重并发症发生率为16.7%,患者术后中位生存时间为22.4个月。结论通过对一期手术采用损伤控制性改进方法,ALPPS可以成为治疗复杂肝脏恶性肿瘤的可靠方法,使没有足够剩余肝脏体积的肝癌患者获得长期生存。
