Fujishima Tomonori, Ishikawa Takashi, Shiratori Yasushi, Kanda Miho, Tateishi Ryosuke, Akamatsu Masatoshi, Koike Yukihiro, Sato Shinpei, Obi Shuntaro, Hamamura Keisuke, Teratani Takuma, Shiina Shuichiro, Yoshida Haruhiko, Kawabe Takao, Omata Masao
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Japan.
Hepatogastroenterology. 2006 Nov-Dec;53(72):913-8.
BACKGROUND/AIMS: It is not known whether the putative etiologic factors and clinical and pathological features of hepatocellular carcinoma differ between young adults and older patients. Therefore this study aims to evaluate whether the clinicopathological features in young patients with HCC significantly differ from those of elderly patients.
A total of 1014 consecutive patients with HCC were divided into two groups based on age. Among them, 73 patients younger than 50 years of age comprised the first group and 941 patients 50 years and older made up the second. Clinical, laboratory, and pathological characteristics were compared between the two age groups.
The male: female ratio and the incidence of positive hepatitis B surface antigen were significantly higher in young patients than in elderly patients. Tumor size, pathological grading of the tumor, and the severity of liver disease did not differ between the two groups. Especially in those patients demonstrating positive antibody to hepatitis C virus, alanine aminotransferase was higher in the younger, and platelet count was lower. Younger patients also had a higher ratio of alcohol consumption compared to elderly patients.
There were age-related differences in the clinicopathological characteristics of HCC patients. Concerning hepatocarcinogenesis, male and HBsAg positive patients were at high risk in young. Of the HCV-related HCC patients, heavy drinking may accelerate the progression from chronic hepatitis to cirrhosis and HCC.
背景/目的：目前尚不清楚肝细胞癌的假定病因以及临床和病理特征在年轻成年人与老年患者之间是否存在差异。因此，本研究旨在评估年轻肝癌患者的临床病理特征是否与老年患者存在显著差异。
总共1014例连续性肝癌患者按年龄分为两组。其中，73例年龄小于50岁的患者组成第一组，941例年龄50岁及以上的患者组成第二组。比较两组患者的临床、实验室及病理特征。
年轻患者的男女比例及乙肝表面抗原阳性率显著高于老年患者。两组患者的肿瘤大小、肿瘤病理分级及肝病严重程度无差异。尤其是在丙肝病毒抗体阳性的患者中，年轻患者的谷丙转氨酶水平较高，血小板计数较低。与老年患者相比，年轻患者的饮酒比例也更高。
肝癌患者的临床病理特征存在年龄相关差异。在肝癌发生方面，年轻男性及乙肝表面抗原阳性患者风险较高。在丙肝相关肝癌患者中，大量饮酒可能加速从慢性肝炎进展为肝硬化及肝癌。
