Watabe Hirotsugu, Shiratori Yasushi, Tateishi Ryousuke, Fujishima Tomonori, Akamatsu Masatoshi, Koike Yukihiro, Obi Shuntaro, Hamamura Keisuke, Sato Shinpei, Teratani Takuma, Shiina Shuichiro, Omata Masao
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Hepatogastroenterology. 2003 Nov-Dec;50(54):2157-60.
BACKGROUND/AIMS: The aim of this study is to clarify the clinical features of hepatocellular carcinoma that are negative for both hepatitis B surface antigen and anti-hepatitis C antibody.
Patients were classified according to viral markers: 45 patients (82%) had hepatitis B (B-HCC), 467 patients (82%) had hepatitis C (C-HCC), and 53 patients (9%) had neither hepatitis B nor hepatitis C (NBNC-HCC). Differences in clinical parameters among these three groups were analyzed.
Patients with NBNC-HCC were older than B-HCC and C-HCC patients. The incidence of alcoholism in NBNC-HCC patients was higher than in C-HCC patients. Patients with NBNC-HCC had similar rates of positive antibody to hepatitis B core antigen as did patients with C-HCC. NBNC-HCC patients were further classified according to median age. The younger group showed a greater tendency towards alcoholism than did the aged group. Liver functioning in the younger group was worse than in the older group. The older group had larger tumors than the younger group.
The livers of younger NBNC-HCC patients were more cirrhotic, possibly because of alcoholism. Older NBNC-HCC patients presented with larger tumors, possibly because they did not receive regular medical check-ups due to their relatively preserved liver function.
背景/目的：本研究旨在阐明乙肝表面抗原和抗丙肝抗体均为阴性的肝细胞癌的临床特征。
根据病毒标志物对患者进行分类：45例患者（82%）患有乙型肝炎（B型肝癌），467例患者（82%）患有丙型肝炎（C型肝癌），53例患者（9%）既无乙型肝炎也无丙型肝炎（非乙非丙型肝癌）。分析这三组患者临床参数的差异。
非乙非丙型肝癌患者比B型肝癌和C型肝癌患者年龄更大。非乙非丙型肝癌患者的酗酒发生率高于C型肝癌患者。非乙非丙型肝癌患者的乙肝核心抗原抗体阳性率与C型肝癌患者相似。非乙非丙型肝癌患者根据年龄中位数进一步分类。较年轻组比老年组酗酒倾向更明显。较年轻组的肝功能比老年组差。老年组的肿瘤比年轻组大。
较年轻的非乙非丙型肝癌患者的肝脏肝硬化程度更高，可能是由于酗酒。老年非乙非丙型肝癌患者的肿瘤更大，可能是因为他们肝功能相对较好而未接受定期体检。
