Dipartimento di Medicina Clinica e delle Patologie Emergenti, Cattedra di Medicina Interna, Università di Palermo, Italy.
Eur J Intern Med. 2010 Apr;21(2):127-30. doi: 10.1016/j.ejim.2009.12.011. Epub 2010 Jan 13.
To analyze the main etiological factors and some clinical characteristics of patients with HCC at diagnosis and to compare them with those we described ten years ago.
179 patients were included in Group 1, while 132 patients were included in Group 2. For all patients age, sex, serum markers of hepatitis B and C viruses, alcohol consumption, serum alpha feto-protein (AFP) levels and the main liver function parameters at HCC diagnosis were recorded.
Mean age was 66.0 years for Group 1 and 69.0 for Group 2 (P=0.005). HCV was responsible for 80.3% of HCC cases in Group 2 versus 72% in Group 1 (P=0.005). HBV alone and co-infection of HCV+HBV decreased, but not significantly. In Group 1 only four patients had an underlying normal liver, while in Group 2 no patients showed an underlying normal liver (P=ns). HCC was more frequently associated with Child class A in Group 2 (P=0.0001), whereas in Group 1 it was more frequently associated with class C (P=0.0001). Staging of HCC correlated inversely when patients of Groups 1 and 2 were compared (P<0.03). AFP serum levels were above normal in 72% of cases in Group 1 and in 41.5% in Group 2 (P=0.0001).
This study shows that over the last decade a number of characteristics of patients with HCC in our region have changed, particularly age at onset of HCC, staging of underlying liver disease and staging of HCC.
分析诊断为 HCC 的患者的主要病因学因素和一些临床特征，并将其与我们十年前描述的特征进行比较。
将 179 例患者纳入第 1 组，132 例患者纳入第 2 组。记录所有患者的年龄、性别、乙型肝炎和丙型肝炎病毒血清标志物、饮酒情况、血清甲胎蛋白（AFP）水平以及 HCC 诊断时的主要肝功能参数。
第 1 组的平均年龄为 66.0 岁，第 2 组为 69.0 岁（P=0.005）。第 2 组中 80.3%的 HCC 病例由 HCV 引起，而第 1 组中这一比例为 72%（P=0.005）。HBV 单独感染和 HCV+HBV 合并感染减少，但无统计学意义。第 1 组中只有 4 例患者存在基础正常肝脏，而第 2 组中没有患者存在基础正常肝脏（P=无统计学意义）。第 2 组 HCC 更常与 Child 分级 A 相关（P=0.0001），而第 1 组 HCC 更常与 Child 分级 C 相关（P=0.0001）。第 1 组和第 2 组患者比较时，HCC 分期呈负相关（P<0.03）。第 1 组中 72%的病例 AFP 血清水平高于正常值，而第 2 组中这一比例为 41.5%（P=0.0001）。
本研究表明，在过去十年中，我们地区 HCC 患者的一些特征发生了变化，特别是 HCC 发病年龄、基础肝病分期和 HCC 分期。
