Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Digestion. 2011;84 Suppl 1:43-9. doi: 10.1159/000333212. Epub 2011 Dec 2.
BACKGROUND/AIMS: To clarify risk factors and clinical features of both hepatitis B surface antigen and anti-HCV negative hepatocellular carcinoma (NBNC-HCC).
HCC patients (n = 1,109) diagnosed at a single center were categorized based on the presence of serum hepatitis B surface antigen and HCVAb. Clinical characteristics of 127 NBNC-HCC patients were evaluated.
NBNC-HCC patients were stratified as those with alcoholic liver disease (ALD-HCC, n = 42) and alcohol-unrelated liver disease (non-ALD-HCC, n = 85). Compared with the ALD-HCC group, the non-ALD-HCC group had a higher prevalence of diabetes (p = 0.015), larger tumor size (p = 0.007), and higher tumor marker levels (p = 0.014). Liver function results were significantly worse in ALD-HCC than in non-ALD-HCC. Although the ALD-HCC group had a higher tendency toward recurrence than the non-ALD-HCC group, survival rates were similar between groups (p = 0.352).
Alcohol consumption was the most common etiologic factor for NBNC-HCC, and diabetes may be related to the development of HCC in non-ALD-HCC patients. Non-ALD-HCC tended to be diagnosed at a more advanced stage, whereas liver function was worse, and tumor recurrence rate was higher in ALD-HCC patients. Further examination of the risk factors and establishment of a precise surveillance system are necessary for early diagnosis and the development of curative therapies for NBNC-HCC.
背景/目的:阐明乙型肝炎表面抗原和抗 HCV 阴性肝细胞癌(NBNC-HCC)的危险因素和临床特征。
在一家中心对 HCC 患者(n = 1,109)进行分类,基于血清乙型肝炎表面抗原和 HCVAb 的存在情况。评估了 127 例 NBNC-HCC 患者的临床特征。
NBNC-HCC 患者分为酒精性肝病(ALD-HCC,n = 42)和酒精无关肝病(非-ALD-HCC,n = 85)。与 ALD-HCC 组相比,非-ALD-HCC 组糖尿病患病率更高(p = 0.015),肿瘤更大(p = 0.007),肿瘤标志物水平更高(p = 0.014)。ALD-HCC 组的肝功能结果明显差于非-ALD-HCC 组。尽管 ALD-HCC 组的复发倾向高于非-ALD-HCC 组,但两组的生存率相似(p = 0.352)。
饮酒是 NBNC-HCC 最常见的病因,糖尿病可能与非-ALD-HCC 患者 HCC 的发生有关。非-ALD-HCC 倾向于在更晚期被诊断,而 ALD-HCC 患者的肝功能更差,肿瘤复发率更高。需要进一步研究危险因素,并建立精确的监测系统,以便对 NBNC-HCC 进行早期诊断和开发治疗方法。