Tangkijvanich Pisit, Suwangool Pongspeera, Mahachai Varocha
Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
J Med Assoc Thai. 2003 Jun;86 Suppl 2:S250-6.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are leading causes hepatocellular carcinoma (HCC) worldwide. The aim of this study was to determine whether differences do exist between HBV- and HCV-associated HCC in terms of clinical, pathologic features and prognosis among Thai patients. The authors retrospectively reviewed the clinical data of 188 patients with pathologically proven HCC, who were admitted to Chulalongkorn Hospital between January 1997 and December 1999. Of these cases, there were 105 patients (55.9%) with hepatitis B surface antigen (HbsAg) positive, 19 patients (10.1%) with anti-HCV positive, and 2 patients (1.0%) with both markers positive. The authors found that the mean age of patients with HBsAg positive was significantly lower than that of anti-HCV positive (49.2 +/- 12.7 and 58.3 +/- 8.9 years, respectively, p = 0.003). In contrast, the mean serum alpha-fetoprotein level of HBsAg positive group was significantly higher than that of anti-HCV positive group (48,583.6 +/- 109,494.1 and 2,022.7 +/- 4,869.1 IU/ml, respectively, p = 0.001). However, there was no difference between the two groups in terms of the severity of underlying liver disease, tumor histology and morphology, clinical staging, and the overall survival rate of the patients. The authors concluded that, among Thai populations, the majority of clinical features and survival of HBV-associated HCC did not differ from those with HCV-associated HCC.
乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)是全球肝细胞癌(HCC)的主要病因。本研究的目的是确定在泰国患者中,HBV相关HCC和HCV相关HCC在临床、病理特征及预后方面是否存在差异。作者回顾性分析了1997年1月至1999年12月在朱拉隆功医院住院的188例经病理证实为HCC患者的临床资料。其中,105例(55.9%)乙型肝炎表面抗原(HbsAg)阳性,19例(10.1%)抗HCV阳性,2例(1.0%)两种标志物均阳性。作者发现,HbsAg阳性患者的平均年龄显著低于抗HCV阳性患者(分别为49.2±12.7岁和58.3±8.9岁,p = 0.003)。相反,HbsAg阳性组的平均血清甲胎蛋白水平显著高于抗HCV阳性组(分别为48,583.6±109,494.1和2,022.7±4,869.1 IU/ml,p = 0.001)。然而,两组在基础肝病严重程度、肿瘤组织学和形态学、临床分期以及患者总生存率方面没有差异。作者得出结论,在泰国人群中,HBV相关HCC的大多数临床特征和生存率与HCV相关HCC并无不同。