Fragatou Soso, Tsourveloudis Ioannis, Manesis George
Thalassaemia Unit, General Athens Hospital G. Gennimatas, Athens, Greece.
Hemoglobin. 2010 Jun;34(3):221-6. doi: 10.3109/03630269.2010.485071.
Hepatocellular carcinoma (HCC), following liver cirrhosis as a complication of chronic hepatitis B or C viruses (HBV or HCV)and iron overload, has been reported in thalassemia patients. This study assessed HCC incidences, the role of iron and possible antitumor activity of chelators in 57 thalassemia major (TM) and nine thalassemia intermedia (TI) patients using deferoxamine (DFO) therapy. Antibodies against HCV were detected in 23/57 (40.4%) TM patients, chronic HCV and cirrhosis were diagnosed in 13/23 (56.5%), 7/12 did not respond to antiviral therapy and 2/7 progressed to HCC (incidence 2/57, 3.5%). Three (33.3%) TI patients with liver siderosis and fibrosis and late introduction of iron chelation developed HCC without a history of hepatitis. The incidence was higher in TI (p = 0.032). The main risk factor for HCC was HCV infection in TM patients but it was iron activity in TI patients. Iron chelation with DFO appeared to play a protective role.
据报道，地中海贫血患者会出现肝细胞癌（HCC），它是慢性乙型或丙型肝炎病毒（HBV或HCV）以及铁过载导致肝硬化后的并发症。本研究评估了57例重型地中海贫血（TM）患者和9例中间型地中海贫血（TI）患者使用去铁胺（DFO）治疗时的HCC发病率、铁的作用以及螯合剂可能的抗肿瘤活性。在23/57（40.4%）的TM患者中检测到抗HCV抗体，13/23（56.5%）被诊断为慢性HCV和肝硬化，7/12对抗病毒治疗无反应，2/7进展为HCC（发病率2/57，3.5%）。3例（33.3%）有肝脏铁沉积和纤维化且铁螯合治疗开始较晚的TI患者在无肝炎病史的情况下发生了HCC。TI患者的发病率更高（p = 0.032）。TM患者发生HCC的主要危险因素是HCV感染，而TI患者是铁活性。用DFO进行铁螯合似乎起到了保护作用。
