Nahon P, Ganne-Carrié N, Trinchet J-C, Beaugrand M
Service d'hépatogastroentérologie, hôpital Jean-Verdier, AP-HP, avenue du 14juillet, 93140 Bondy, France.
Gastroenterol Clin Biol. 2010 Jan;34(1):1-7. doi: 10.1016/j.gcb.2009.07.032. Epub 2009 Sep 16.
Iron accumulation in the liver is considered to be a co-factor for progression of liver disease. Iron overload can enhance the effects of oxidative stress and influence the natural history of patients with cirrhosis, exposing them to a higher risk of hepatocellular carcinoma. The results of clinical studies designed to assess the impact of liver iron content on the risk of tumor development have remained controversial for some time. It is known that common factors can affect both liver iron overload and the risk of cancer, necessitating multivariate analyses of these features in large cohorts of cirrhotic patients. Furthermore, the causes and consequences of hepatic iron overload appear to depend on the cause of the underlying liver disease. Thus, the only solid evidence of a relationship between liver iron overload and event occurrence has come from longitudinal studies conducted in homogeneous cohorts of patients with cirrhosis. So far, the available data suggest that iron accumulation in the liver is an independent risk factor for hepatocellular carcinoma in patients with alcoholic cirrhosis and/or nonalcoholic hepatosteatosis, but not in those with viral hepatitis C cirrhosis.
肝脏中铁的蓄积被认为是肝病进展的一个辅助因素。铁过载可增强氧化应激的影响，并影响肝硬化患者的自然病程，使他们面临更高的肝细胞癌风险。旨在评估肝脏铁含量对肿瘤发生风险影响的临床研究结果在一段时间内一直存在争议。已知常见因素可同时影响肝脏铁过载和癌症风险，因此有必要在大量肝硬化患者队列中对这些特征进行多变量分析。此外，肝脏铁过载的原因和后果似乎取决于潜在肝脏疾病的病因。因此，肝脏铁过载与事件发生之间关系的唯一确凿证据来自对肝硬化患者同质性队列进行的纵向研究。到目前为止，现有数据表明，肝脏中铁的蓄积是酒精性肝硬化和/或非酒精性肝脂肪变性患者肝细胞癌的独立危险因素，但在丙型病毒性肝炎肝硬化患者中并非如此。
