Department of Internal Medicine, The Catholic University of Korea, Seoul 137-701, South Korea.
World J Gastroenterol. 2012 Jun 7;18(21):2661-7. doi: 10.3748/wjg.v18.i21.2661.
To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients.
We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008, whose family history of primary liver cancer was clearly described in the medical records.
Of the 2242 patients, 165 (7.4%) had a positive family history of HCC and 2077 (92.6%) did not. The male to female ratio was 3.6:1, and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1%, chronic hepatitis C virus infection in 13.2% and alcohol in 3.1%. The median ages at diagnosis in the positive- and negative-history groups were 52 years (range: 29-79 years) and 57 years (range: 18-89 years), respectively (P < 0.0001). Furthermore, among 1713 HCC patients with HBV infection, the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1%), whereas those out of 1577 patients with negative family history was 197 (12.5%), suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P = 0.0028).
More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.
评估韩国 HCC 患者中一级亲属肝癌阳性史与肝细胞癌(HCC)发生之间的关系。
我们共研究了 2242 例 1990 年 1 月至 2008 年 7 月期间诊断为 HCC 的患者,这些患者的病历中明确描述了一级亲属肝癌的家族史。
在 2242 例患者中,有 165 例(7.4%)存在 HCC 阳性家族史,2077 例(92.6%)不存在。男女比例为 3.6:1,HCC 的主要病因是慢性乙型肝炎病毒(HBV)感染占 75.1%,慢性丙型肝炎病毒感染占 13.2%,酒精占 3.1%。阳性家族史组和阴性家族史组的中位诊断年龄分别为 52 岁(范围:29-79 岁)和 57 岁(范围:18-89 岁)(P<0.0001)。此外,在 1713 例 HBV 感染的 HCC 患者中,有阳性家族史的 136 例患者中年龄小于 45 岁的患者有 26 例(19.1%),而阴性家族史的 1577 例患者中年龄小于 45 岁的患者有 197 例(12.5%),这表明阳性家族史可能与韩国人群中 HCC 的较早发生有关(P=0.0028)。
对于有 HCC 阳性家族史的患者,建议进行更密集的监测,以便及早诊断和适当管理,特别是当存在 HBV 感染时。