Davcev P, Bidikov V, Stavrić D, Serafimovski V, Trajanovski D, Neskovski M, Zografski D
Makedonska akademija nauka i umetnosti, Skopje.
Med Pregl. 1990;43(11-12):457-61.
Out of 99 histologically verified carcinomas (HCC), 73 (73.7%) belonged to HCC with associated cirrhosis and 26 (26.2%) belonged to HCC without cirrhosis. The relatively high incidence of HBsAg in the serum of patients with non-cirrhotic HCC (57.6%) shows that HBV infection persistence could be, one of the very important bases for HCC development, more than cirrhosis itself. The negative finding of HBsAg in the serum couldn't exclude the possibility of an integrated HBV genome in the cirrhotic tissue. There is an alternative possibility of an induced infection with hepatitis NANB (transfusions). A non-significant inclination towards younger age groups exists in non-cirrhotic HCC. Males are predominant in both groups, but females are more present in non-cirrhotic HCC than in cirrhotic HCC. The clinical course of non-cirrhotic HCC is usually slower; often there are no signs of portal hypertension or surrounding organ involvement, which offers better prognostic prospects than cirrhotic HCC. In relation to cirrhotic HCC, patients with non-cirrhotic HCC had a less frequent history of hepatitis (19.2%), a higher albumin-globulin ratio (1.5) and lower values in serum alpha-1 fetoprotein elevation (53.8%). Ultrasonographically, HCC without cirrhosis is presented with a mono-nodular shape in the majority of cases, or as a primary and dominant form, with surrounding satellite lesions even within the other lobe. Pathoanatomic findings usually show massive, compact, solid tissue formation alone, or accompanied by satellite lesions. Histologically, there is low-degree evolution with minimal necrosis and mild mitotic activity with a presence of minimal fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)
在99例经组织学证实的肝癌(HCC)中,73例(73.7%)属于伴有肝硬化的HCC,26例(26.2%)属于无肝硬化的HCC。非肝硬化性HCC患者血清中HBsAg的相对高发生率(57.6%)表明,HBV感染持续存在可能是HCC发生的非常重要的基础之一,甚至超过肝硬化本身。血清中HBsAg阴性结果不能排除肝硬化组织中存在整合型HBV基因组的可能性。存在丙型肝炎病毒(输血引起)诱导感染的另一种可能性。非肝硬化性HCC患者有向年轻年龄组发展的不显著倾向。两组中男性均占主导,但非肝硬化性HCC中的女性比肝硬化性HCC中的女性更多。非肝硬化性HCC的临床病程通常较慢;通常没有门静脉高压或周围器官受累的迹象,这比肝硬化性HCC具有更好的预后前景。与肝硬化性HCC相比,非肝硬化性HCC患者肝炎病史较少(19.2%),白蛋白球蛋白比值较高(1.5),血清甲胎蛋白升高值较低(53.8%)。超声检查显示,大多数无肝硬化的HCC呈单结节状,或作为主要和占主导的形式,甚至在另一叶内也有周围卫星病灶。病理解剖学发现通常仅显示大量、致密、实性组织形成,或伴有卫星病灶。组织学上,有低度进展,坏死极少,有轻度有丝分裂活性,纤维化极少。(摘要截选至250字)