Karolinska Institute, Stockholm, Sweden.
Dig Liver Dis. 2010 Jul;42 Suppl 3(Suppl 3):S206-14. doi: 10.1016/S1590-8658(10)60507-5.
Primary liver cancer (PLC) represents approximately 4% of all new cancer cases diagnosed worldwide. The purpose of this review is to describe some of the latest international patterns in PLC incidence and mortality, as well as to give an overview of the main etiological factors. We used two databases, GLOBOCAN 2002 and the World Health Organization (WHO) mortality database to analyze the incidence and mortality rates for PLC in several regions around the world. The highest age adjusted incidence rates (>20 per 100,000) were reported from countries in Southeast Asia and sub-Saharan Africa that are endemic for HBV infection. Countries in Southern Europe have medium-high incidence rates, while low-incidence areas (<5 per 100,000) include South and Central America, and the rest of Europe. Cirrhosis is present in about 80-90% of HCC patients and is thereby the largest single risk factor. Main risk factors include HBV, HCV, aflatoxin and possibly obesity and diabetes. Together HBV and HCV account for 80-90% of all HCC worldwide. HBV continues to be the major HCC risk factor worldwide, although its importance will most likely decrease during the coming decades due to the widespread use of the HBV vaccine in the newborns. HCV has been the dominant viral cause in HCC in North America, some Western countries and Japan. Obesity and diabetes are increasing at a fast pace throughout the world, and if they are proven to be HCC risk factors, they would account for more HCC cases in the future.
原发性肝癌（PLC）约占全球新诊断癌症病例的 4%。本综述旨在描述 PLC 发病率和死亡率的一些最新国际趋势，并概述主要的病因因素。我们使用了两个数据库，即 GLOBOCAN 2002 和世界卫生组织（WHO）死亡率数据库，分析了全球多个地区 PLC 的发病率和死亡率。在东南亚和撒哈拉以南非洲等乙型肝炎病毒（HBV）感染流行的国家，报告的年龄调整发病率最高（>20/10 万）。南欧国家的发病率处于中高水平，而发病率较低的地区（<5/10 万）包括南美洲和中美洲以及欧洲其他地区。大约 80-90%的 HCC 患者存在肝硬化，因此是最大的单一危险因素。主要危险因素包括 HBV、HCV、黄曲霉毒素，可能还包括肥胖和糖尿病。HBV 和 HCV 共同导致了全球 80-90%的 HCC。HBV 仍然是全球 HCC 的主要危险因素，但由于在新生儿中广泛使用乙肝疫苗，其重要性在未来几十年可能会降低。HCV 一直是北美的 HCC、一些西方国家和日本的主要病毒病因。肥胖和糖尿病在全球范围内迅速增加，如果它们被证明是 HCC 的危险因素，那么它们将在未来导致更多的 HCC 病例。
