Tanabe G, Nuruki K, Baba Y, Imamura Y, Miyazono N, Ueno K, Arima T, Nakajyou M, Aikou T
First Department of Surgery, Kagoshima University, School of Medicine, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2442-6.
BACKGROUND/AIMS: Close relationships between hepatocellular carcinoma (HCC) and hepatitis virus infection have been elucidated. However, clinical differences between HBV- and HCV-associated HCC remain unclear.
Four hundred and sixteen patients with HCC were examined for both HBsAg and HCV-Ab. Sixty-nine of the 416 patients (16.6%) were positive for HBsAg and negative for HCV-Ab (B-HCC), while 290 patients (69.7%) were negative for HBsAg and positive for HCV-Ab (C-HCC). Various comparisons were made between the 2 groups.
B-HCC patients were younger in age (p < 0.0001), and had significantly better liver function than C-HCC patients. The motivation of HCC detection was different between the 2 groups (p < 0.0001), and the tumor size of B-HCC was significantly larger when comparing groups with regard to symptoms (p < 0.05). Although B-HCC demonstrated better survival in Stage I/II treated by surgery (p < 0.05), it was associated with poorer survival in Stage III/IV receiving hepatic arterial infusion chemotherapy when compared to C-HCC (p < 0.01).
These results suggest that clinical differences between B-HCC and C-HCC may depend upon the difference of the natural course between HBV and HCV infection, and B-HCC may be more resistant to treatment than C-HCC in the advanced stage. This also illustrates the need for early tumor detection in B-HCC.
背景/目的:肝细胞癌(HCC)与肝炎病毒感染之间的密切关系已得到阐明。然而,HBV相关HCC和HCV相关HCC之间的临床差异仍不清楚。
对416例HCC患者进行HBsAg和HCV-Ab检测。416例患者中有69例(16.6%)HBsAg阳性且HCV-Ab阴性(B-HCC),而290例患者(69.7%)HBsAg阴性且HCV-Ab阳性(C-HCC)。对两组进行了各种比较。
B-HCC患者年龄较小(p<0.0001),肝功能明显优于C-HCC患者。两组HCC检测的动机不同(p<0.0001),在比较有症状组时,B-HCC的肿瘤大小明显更大(p<0.05)。虽然B-HCC在I/II期接受手术治疗时生存率较好(p<0.05),但与C-HCC相比,在III/IV期接受肝动脉灌注化疗时生存率较差(p<0.01)。
这些结果表明,B-HCC和C-HCC之间的临床差异可能取决于HBV和HCV感染自然病程的差异,并且在晚期B-HCC可能比C-HCC对治疗更具抗性。这也说明了B-HCC早期肿瘤检测的必要性。