肝细胞癌高危人群的背景因素分析与评估

Analysis of background factors and evaluation of a population at high risk of hepatocellular carcinoma.

作者信息

Miyazawa Kouji, Moriyama Mitsuhiko, Mikuni Morio, Matsumura Hiroshi, Aoki Hiroshi, Shimizu Toshihiro, Yamagami Hiroaki, Kaneko Miki, Shioda Atsuo, Tanaka Naohide, Arakawa Yasuyuki

机构信息

Third Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.

出版信息

Intervirology. 2003;46(3):150-6. doi: 10.1159/000071455.

DOI:10.1159/000071455

PMID:12867752

Abstract

OBJECTIVE

We investigated the background clinical factors of patients with hepatocellular carcinoma (HCC) diagnosed at our institute and, from these results, determined those factors important for evaluation of a population at high risk of HCC.

METHODS

This study comprised 250 patients diagnosed with HCC from 1990 through 1995 in the Nihon University Itabashi Hospital. Background clinical factors, such as the results of blood chemistry at the time of the first angiography, were examined.

RESULTS

Markers of viral hepatitis in the 250 cases were as follows: type B (B-HCC), 29 (11.6%), type C (C-HCC), 201 (80.4%); type B+C, 3 (1.2%), and non-B, non-C (NBNC-HCC), 17 (6.8%). Approximately 35% of B-HCC and NBNC-HCC cases, but only 6% of C-HCC cases, exhibited platelet counts (PLT) equal to or more than 200,000/ml. On the other hand, 56.5% of the C-HCC cases exhibited PLT less than 100,000/ml, in contrast to less than 30% of the B-HCC and NBNC-HCC cases. Irrespective of the etiology of HCC, male sex and a history of smoking were characteristic risk factors. The percentages of abnormal results in combinations of tests in the B-HCC, C-HCC and NBNC-HCC subsets were: 69, 97 and 70% in the aspartate aminotransferase (AST) + PLT group (group A); 83, 98 and 70% in the group A + alanine aminotransferase (ALT) group (group B), and 86, 98 and 100% in the group B + gamma-glutamyl transpeptidase (gamma-GTP) group (group C), respectively. When hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV-Ab) were also taken into account, abnormal results were found in every case in all of the HCC groups.

CONCLUSION

C-HCC was found predominantly in cases with liver cirrhosis, whereas B-HCC and NBNC-HCC were observed more frequently in cases without liver cirrhosis. Testing for HBsAg and HCV-Ab, in addition to AST, ALT, PLT and gamma-GTP, is considered necessary when screening for HCC.

摘要

目的

我们调查了在我院诊断为肝细胞癌（HCC）患者的临床背景因素，并根据这些结果确定了对评估HCC高危人群重要的因素。

方法

本研究纳入了1990年至1995年在日本大学板桥医院诊断为HCC的250例患者。检查了背景临床因素，如首次血管造影时的血液化学检查结果。

结果

250例患者的病毒性肝炎标志物如下：B型（B-HCC），29例（11.6%）；C型（C-HCC），201例（80.4%）；B+C型，3例（1.2%）；非B非C型（NBNC-HCC），17例（6.8%）。约35%的B-HCC和NBNC-HCC病例血小板计数（PLT）等于或高于200,000/ml，但C-HCC病例中只有6%。另一方面，56.5%的C-HCC病例PLT低于100,000/ml，而B-HCC和NBNC-HCC病例中这一比例不到30%。无论HCC的病因如何，男性和吸烟史都是典型的危险因素。B-HCC、C-HCC和NBNC-HCC亚组中各项检查组合的异常结果百分比分别为：天冬氨酸转氨酶（AST）+PLT组（A组）为69%、97%和70%；A组+丙氨酸转氨酶（ALT）组（B组）为83%、98%和70%；B组+γ-谷氨酰转肽酶（γ-GTP）组（C组）为86%、98%和100%。当同时考虑乙肝表面抗原（HBsAg）和丙肝抗体（HCV-Ab）时，所有HCC组的每个病例均发现异常结果。