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中华普外科手术学杂志(电子版) ›› 2026, Vol. 20 ›› Issue (05) : 490 -494. doi: 10.3877/cma.j.issn.1674-3946.2026.05.018

综述

基于原发肿瘤类型的继发性肝癌发病特征与预后研究进展
杨雷, 王文强, 徐竟益, 王爽, 梁悦华, 闫军†()   
  1. 102218 北京,清华大学北京清华长庚医院肝胆胰外科
  • 收稿日期:2026-03-13 出版日期:2026-10-26
  • 通信作者: 闫军

Research progress on the incidence characteristics and prognosis of secondary liver cancer based on the type of primary tumor

Lei Yang, Wenqiang Wang, Jingyi Xu, Shuang Wang, Yuehua Liang, Jun Yan†()   

  1. Department of Hepatobiliary Pancreatic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
  • Received:2026-03-13 Published:2026-10-26
  • Corresponding author: Jun Yan
引用本文:

杨雷, 王文强, 徐竟益, 王爽, 梁悦华, 闫军. 基于原发肿瘤类型的继发性肝癌发病特征与预后研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2026, 20(05): 490-494.

Lei Yang, Wenqiang Wang, Jingyi Xu, Shuang Wang, Yuehua Liang, Jun Yan. Research progress on the incidence characteristics and prognosis of secondary liver cancer based on the type of primary tumor[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(05): 490-494.

继发性肝癌,亦称肝转移癌,是源自全身其他部位恶性肿瘤的肝脏转移性病变,其发病率高、预后差,是肿瘤晚期患者死亡的主要原因之一。本文系统综述了不同原发肿瘤来源的继发性肝癌在流行病学、发病机制、临床特征及预后方面的研究进展。文章首先阐述了继发性肝癌的基本概念与转移机制,随后分别聚焦于结直肠癌、神经内分泌肿瘤、胃癌、胃肠间质瘤、胰腺癌、胆道肿瘤、乳腺癌、女性生殖系统肿瘤、肺癌、黑色素瘤及肾癌等常见原发肿瘤所致肝转移的临床特点与研究现状。通过对各类型肝转移的发生率、转移模式、分子生物学特征及治疗策略的梳理,本文揭示了继发性肝癌在原发肿瘤类型层面上的显著异质性,强调了个体化诊疗策略在临床实践中的重要性。未来研究应进一步探索不同类型肝转移的分子机制,优化转化治疗与手术时机,以期改善患者预后。

Secondary liver cancer, also known as liver metastatic cancer, is a type of lesion that occurs in the liver due to metastasis from malignant tumors in other parts of the body. It has a high incidence rate and poor prognosis, and is one of the main causes of death for patients with advanced tumors. This article systematically reviews the research progress in epidemiology, pathogenesis, clinical characteristics, and prognosis of secondary liver cancer caused by different primary tumor sources. The article first elaborates on the basic concepts and metastasis mechanisms of secondary liver cancer, and then focuses separately on the clinical characteristics and research status of liver metastasis caused by common primary tumors such as colorectal cancer, neuroendocrine tumors, gastric cancer, gastrointestinal stromal tumors, pancreatic cancer, biliary tract tumors, breast cancer, female reproductive system tumors, lung cancer, melanoma, and kidney cancer. Through the review of the incidence rates, metastasis patterns, molecular biological characteristics, and treatment strategies of each type of liver metastasis, this article reveals the significant heterogeneity of secondary liver cancer at the level of primary tumor types, and emphasizes the importance of individualized treatment strategies in clinical practice. Future research should further explore the molecular mechanisms of different types of liver metastasis, optimize conversion therapy and surgical timing, in order to improve patient prognosis.

[1]
Tsilimigras DI,Brodt P,Clavien PA,et al. Liver metastases[J]. Nature Reviews Disease Primers,2021,7(1): 27.
[2]
Hess KR,Varadhachary GR,Taylor SH,et al. Metastatic patterns in adenocarcinoma[J]. Cancer,2006,106(7): 1624-1633.
[3]
Paget S.Stephen Paget's paper reproduced from The Lancet,1889[J]. Cancer and Metastasis Reviews,1989,8(2): 98-101.
[4]
Horn SR,Stoltzfus KC,Lehrer EJ,et al. Epidemiology of liver metastases[J]. Cancer Epidemiology,2020,67: 101760.
[5]
Wagner JS,Adson MA,Van Heerden JA,et al. The Natural History of Hepatic Metastases from Colorectal Cancer: A Comparison with Resective Treatment[J]. Annals of Surgery,1984,199(5): 502-508.
[6]
唐旭,韩冰,刘威,等. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J/OL]. 中华普外科手术学杂志(电子版),2024,18(1): 16-20.
[7]
Chan AKC,Siriwardena AK. Management of Colorectal Cancer with Synchronous Liver Metastases: A systematic review of national and International Clinical Guidelines(CoSMIC-G)[J]. Surg Open Sci,2024,22: 61-66.
[8]
Gumiero JL,Oliveira BMS,Neto PAO,et al. Timing of resection of synchronous colorectal liver metastasis: A systematic review and meta-analysis[J]. J Surg Oncol,2022,126(1): 175-188.
[9]
Spaander MCW,Zauber AG,Syngal S,et al. Young-onset colorectal cancer[J]. Nat Rev Dis Primers,2023,9(1): 21.
[10]
Piercey O,Tie J,Hollande F,et al. BRAFV600E-Mutant Metastatic Colorectal Cancer: Current Evidence,Future Directions,and Research Priorities[J]. Clinical Colorectal Cancer,2024,23(3): 215-229.
[11]
Reboux N,Jooste V,Goungounga J,et al. Incidence and Survival in Synchronous and Metachronous Liver Metastases From Colorectal Cancer[J]. JAMA Netw Open,2022,5(10): e2236666.
[12]
Cloyd JM,Ejaz A,Konda B,et al. Neuroendocrine liver metastases: a contemporary review of treatment strategies[J]. Hepatobiliary Surgery and Nutrition,2020,9(4): 440-451.
[13]
Dasari A,Wallace K,Halperin DM,et al. Epidemiology of Neuroendocrine Neoplasms in the US[J]. JAMA Netw Open,2025,8(6): e2515798.
[14]
Sonbol MB,Mazza GL,Mi L,et al. Survival and Incidence Patterns of Pancreatic Neuroendocrine Tumors Over the Last 2 Decades: A SEER Database Analysis[J]. The Oncologist,2022,27(7): 573-578.
[15]
中华人民共和国国家卫生健康委员会医政医管局. 胃癌诊疗指南(2022年版)[J]. 中华消化外科杂志,2022,21(9): 1137-1164.
[16]
Liu T,Bai Y,Lin X,et al. First-line nivolumab plus chemotherapy vs chemotherapy in patients with advanced gastric,gastroesophageal junction and esophageal adenocarcinoma: CheckMate 649 Chinese subgroup analysis[J]. International Journal of Cancer,2023,152(4): 749-760.
[17]
伍通美,杨春燕. 胃癌异时性肝转移外科与转化治疗研究进展[J/OL]. 中华普外科手术学杂志(电子版),2026,20(1): 78-82.
[18]
Yanagawa S,Tanabe K,Kano M,et al. Clinicopathological features of hepatoid adenocarcinoma of the stomach: A multicenter retrospective study[J]. Cancer Rep(Hoboken),2024,7(6): e2101.
[19]
Ling Q,Liu HL,Huang ST,et al. Clinicopathological features of hepatoid adenocarcinoma and non-hepatoid adenocarcinoma of the stomach: A systematic review and meta-analysis[J]. Cancer Med,2024,13(16): e70130.
[20]
梁华元,李国新,赵丽瑛. 胃癌肝转移综合诊疗进展[J]. 中华普通外科杂志,2023,38(11): 867-872.
[21]
汪明,曹晖. 靶向药物时代背景下进展期胃肠间质瘤手术治疗相关的若干问题之再思考[J]. 中华胃肠外科杂志,2024,27(11): 1107-1116.
[22]
Hu B,Ye Y,Gao Z. The benefit of surgery during systematic therapy for gastrointestinal stromal tumor liver metastasis: a SEER-based retrospective study[J]. Gastroenterology Report,2024,12: goae095.
[23]
李灼非,高志冬,吕国庆,等. 腹腔镜手术治疗胃间质瘤的进展及争议[J]. 中华普通外科杂志,2022,37(10): 793-796.
[24]
Nichetti F,Rota S,Ambrosini P,et al. NALIRIFOX,FOLFIRINOX,and Gemcitabine With Nab-Paclitaxel as First-Line Chemotherapy for Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis[J]. JAMA Netw Open,2024,7(1): e2350756.
[25]
Ouyang H,Ma W,Si T,et al. Systemic Chemotherapy With or Without Hepatic Arterial Infusion Chemotherapy for Liver Metastases From Pancreatic Cancer: A Propensity Score Matching Analysis[J]. Clin Colorectal Cancer,2023,22(1): 111-119.
[26]
Roa JC,García P,Kapoor VK,et al. Gallbladder cancer[J]. Nature Reviews Disease Primers,2022,8(1): 69.
[27]
中国研究型医院学会肝胆胰外科专业委员会,《中华消化外科杂志》编辑委员会. 肝门部胆管癌诊断和治疗指南(2025版)[J]. 中华消化外科杂志,2025,24(1): 1-20.
[28]
中国抗癌协会. 远端胆管癌规范化诊治专家共识(2017)[J]. 中华肝胆外科杂志,2018,24(1): 1-8.
[29]
科技部传染病防治重大专项课题“病毒性肝炎相关肝癌外科综合治疗的个体化和新策略研究”专家组. 肝内胆管癌外科治疗中国专家共识(2020版)[J]. 中华消化外科杂志,2021,20(1): 1-15.
[30]
中华医学会外科学分会胆道外科学组,中国医师协会外科医师分会胆道外科专业委员会. 胆囊癌诊断和治疗指南(2019版)[J]. 中华外科杂志,2020,58(4): 243-251.
[31]
Huang X,Chen W,Liu J,et al. Clinicopathological features,prognostic factors,and prognostic survival prediction in patients with extrahepatic bile duct cancer liver metastasis[J]. Eur J Gastroenterol Hepatol,2024,36(8): 1029-37.
[32]
黄明山,杨刚,张宇波,等. 远端胆管癌根治术后Nomogram预测模型的构建及内部验证[J]. 中国基层医药,2025,32(5): 699-705.
[33]
Cho SM,Esmail A,Raza A,et al. Timeline of FDA-Approved Targeted Therapy for Cholangiocarcinoma[J]. Cancers,2022,14(11): 2641.
[34]
Oh DY,Ruth He A,Qin S,et al. Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer[J]. NEJM Evid,2022,1(8): EVIDoa2200015.
[35]
Bray F,Laversanne M,Sung H,et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA: A Cancer Journal for Clinicians,2024,74(3): 229-263.
[36]
Benitez Fuentes JD,Morgan E,de Luna Aguilar A,et al. Global Stage Distribution of Breast Cancer at Diagnosis: A Systematic Review and Meta-Analysis[J]. JAMA Oncology,2024,10(1): 71-78.
[37]
刘柏杨,周冲,韩亮. 基于SEER数据库研究原发灶手术对初诊Ⅳ期乳腺癌的预后影响[J]. 中华转移性肿瘤杂志,2025,08(1): 64-72.
[38]
Salarzaei M,van de Laar RLO,Ewing-Graham PC,et al. Unraveling Differences in Molecular Mechanisms and Immunological Contrasts between Squamous Cell Carcinoma and Adenocarcinoma of the Cervix[J]. Int J Mol Sci,2024,25(11): 6205.
[39]
殷卓敏,唐华容,袁淑慧,等. 80例ⅣB期血道转移宫颈鳞癌预后分析[J]. 中华放射肿瘤学杂志,2021,30(12): 1262-1267.
[40]
李盼盼,苏玥辉,张梦真. 子宫颈癌术后肝转移13例临床分析[J]. 中华妇产科杂志,2020,55(4): 266-272.
[41]
Kuhn TM,Dhanani S,Ahmad S. An Overview of Endometrial Cancer with Novel Therapeutic Strategies[J]. Curr Oncol,2023,30(9): 7904-7919.
[42]
Di Donato V,Giannini A,D’Oria O,et al. Hepatobiliary Disease Resection in Patients with Advanced Epithelial Ovarian Cancer: Prognostic Role and Optimal Cytoreduction[J]. Annals of Surgical Oncology,2021,28(1): 222-230.
[43]
Gardner AB,Charo LM,Mann AK,et al. Ovarian,uterine,and cervical cancer patients with distant metastases at diagnosis: most common locations and outcomes[J]. Clinical &Experimental Metastasis,2020,37(1): 107-713.
[44]
中国医疗保健国际交流促进会肿瘤内科学分会,中国医师协会肿瘤医师分会. Ⅳ期原发性肺癌中国治疗指南(2024版)[J]. 中华肿瘤杂志,2024,46(7): 595-636.
[45]
Ćeriman Krstić V,Samardžić N,Gajić M,et al. Treatment Options for Patients with Non-Small Cell Lung Cancer and Liver Metastases[J]. Curr Issues Mol Biol,2024,46(12): 13443-13455.
[46]
Brown LJ,Ahn J,Gao B,et al. Site-Specific Response and Resistance Patterns in Patients with Advanced Non-Small-Cell Lung Cancer Treated with First-Line Systemic Therapy[J]. Cancers(Basel),2024,16(11): 2136.
[47]
Wu Y,Zhang J,Zhou W,et al. Prognostic factors in extensive-stage small cell lung cancer patients with organ-specific metastasis: unveiling commonalities and disparities[J]. J Cancer Res Clin Oncol,2024,150(2): 74.
[48]
Cittolin-Santos GF,Knapp B,Ganesh B,et al. The changing landscape of small cell lung cancer[J]. Cancer,2024,130(14): 2453-2461.
[49]
Liu A,Zhang G,Yang Y,et al. Two nomograms constructed for predicting the efficacy and prognosis of advanced non‑small cell lung cancer patients treated with anti‑PD‑1 inhibitors based on the absolute counts of lymphocyte subsets[J]. Cancer Immunol Immunother,2024,73(8): 152.
[50]
Vergara IA,Lo SN,Li I,et al. Sites of metastases before systemic treatment influence progression patterns and survival in stage IV melanoma patients[J]. Immunooncol Technol,2025,28: 101078.
[51]
Flem-Karlsen K,Talty R,McGeary MK,et al. Cytotoxic CD8+ T Cells Downregulate GPX4 to Promote Ferroptosis in Melanoma That Drives Antitumor Immunity[J]. Cancer Res,2025,85(21): 4139-4150.
[52]
Grant KG,Gillespie Y,Karamian A,et al. Evolving treatment paradigms for melanoma brain metastases: A systematic review of current modalities[J]. Clin Neurol Neurosurg,2025,257: 109025.
[53]
Weinberger Y,Bena J,Singh AD. Uveal Melanoma: 5-Year Update on Incidence,Treatment,and Survival(SEER 1975-2020)[J]. Ocul Oncol Pathol,2025,11(1): 30-36.
[54]
Zaman FY,Ghaus A,Shackleton M,et al. Systemic Surveillance Guidelines for Uveal Melanoma: A Systematic Review[J]. Clin Exp Ophthalmol,2026,54(1): 99-112.
[55]
Granieri S,Altomare M,Bruno F,et al. Surgical treatment of gastric cancer liver metastases: Systematic review and meta-analysis of long-term outcomes and prognostic factors[J]. Crit Rev Oncol Hematol,2021,163: 103313.
[56]
Rose DM,Essner R,Hughes TMD,et al. Surgical Resection for Metastatic Melanoma to the Liver: The John Wayne Cancer Institute and Sydney Melanoma Unit Experience[J]. Archives of Surgery,2001,136(8): 950-955.
[57]
Padala SA,Barsouk A,Thandra KC,et al. Epidemiology of Renal Cell Carcinoma[J]. World journal of oncology,2020,11(3): 79-87.
[58]
国家癌症中心,国家肿瘤质控中心肾癌质控专家委员会. 中国肾癌规范诊疗质量控制指标(2022版)[J]. 中华肿瘤杂志,2022,44(12): 1256-61.
[59]
Wang Z,Xu C,Liu W,et al. A clinical prediction model for predicting the risk of liver metastasis from renal cell carcinoma based on machine learning[J]. Front Endocrinol(Lausanne),2022,13: 1083569.
[60]
Chen H,Zeng Q,Liu F,et al. Fumarate hydratase-deficient renal cell carcinoma complicated with liver metastasis: case report[J]. Front Surg,2024,11: 1430344.
[61]
Hasselgren K,Bencherki A,Short J,et al. Survival Outcomes and Risk Factors for Liver and Pancreatic Metastases in Renal Cell Carcinoma after Curative Nephrectomy[J]. BMC urology,2025,25(1): 1-8.
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