非酒精性脂肪性肝病或丙型肝炎导致的老年日本患者慢性肝病恶性肿瘤的差异。

Difference in malignancies of chronic liver disease due to non-alcoholic fatty liver disease or hepatitis C in Japanese elderly patients.

机构信息

Department of Hepatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Department of Health Management Center, Toranomon Hospital, Tokyo Department of Third Internal Medicine (Metabolism), University of Yamanashi, Yamanashi, Japan.

出版信息

Hepatol Res. 2012 Mar;42(3):264-72. doi: 10.1111/j.1872-034X.2011.00915.x. Epub 2011 Dec 19.

DOI:10.1111/j.1872-034X.2011.00915.x

PMID:22175908

Abstract

AIM

Malignancies that include hepatocellular carcinoma often occurred in patients with chronic liver disease. The aim of this retrospective match control study was to assess the cumulative development incidence and predictive factors for total malignancies in elderly Japanese patients with non-alcoholic hepatic diseases (NAFLD) or hepatitis C virus (HCV).

METHODS

A total of 1600 NAFLD patients with age of ≥60 years were enrolled, and 1600 HCV patients with age of ≥60 years were selected as control by matching 1:1 with NAFLD group for age, sex, and follow-up period. The primary goal is the first development of malignancies. Evaluation was performed by the use of the Wilcoxon rank sum test, the Kaplan-Meier method, and Cox proportional hazard model. The mean observation period is 8.2 years in both NAFLD and HCV group, respectively.

RESULTS

The number of patients with the development of malignancies was 167 in the NAFLD group and 395 in the HCV group. The 10th development rate of malignancies was 13.9% in the NAFLD group and 28.2% in the HCV group (risk ratio 2.27; P < 0.001). The incident rates of hepatocellular carcinoma in all the malignancies were 6.0% (10/167) in the NAFLD group and 67.6% (267/395) in the HCV group (P < 0.001). The malignancies in the NAFLD group were observed in the following order: gastric cancer 34 cases (20.4%) > colon cancer 31 cases (18.6%) > prostate cancer 21 cases (12.6%).

CONCLUSIONS

The incident rates of hepatocellular carcinoma in all the malignancies were approximately 6% in the NAFLD group and two-thirds in the HCV group.

摘要

目的

包括肝细胞癌在内的恶性肿瘤常发生于慢性肝病患者中。本回顾性匹配对照研究旨在评估非酒精性肝病（NAFLD）或丙型肝炎病毒（HCV）老年患者中总恶性肿瘤的累积发生发生率和预测因素。

方法

共纳入 1600 例年龄≥60 岁的 NAFLD 患者，并通过年龄、性别和随访期与 NAFLD 组 1:1 匹配选择 1600 例年龄≥60 岁的 HCV 患者作为对照。主要目标是首次发生恶性肿瘤。采用 Wilcoxon 秩和检验、Kaplan-Meier 法和 Cox 比例风险模型进行评估。NAFLD 组和 HCV 组的平均观察期分别为 8.2 年。

结果

NAFLD 组中有 167 例患者发生恶性肿瘤，HCV 组中有 395 例。NAFLD 组第 10 次恶性肿瘤发展率为 13.9%，HCV 组为 28.2%（风险比 2.27；P<0.001）。所有恶性肿瘤中肝细胞癌的发生率，NAFLD 组为 6.0%（10/167），HCV 组为 67.6%（267/395）（P<0.001）。NAFLD 组的恶性肿瘤依次为胃癌 34 例（20.4%）>结肠癌 31 例（18.6%）>前列腺癌 21 例（12.6%）。