Department of Nutritional Carcinogenesis, IRCCS de Bellis, National Institute for Digestive Diseases, Castellana Grotte, Italy. brianicarr @ hotmail.com
Oncology. 2012;83(6):331-8. doi: 10.1159/000341533. Epub 2012 Sep 18.
Clinical phenotypes of small and large hepatocellular carcinomas (HCCs) are not well characterized.
To evaluate the characteristics of small HCCs diagnosed by screening.
A cohort of 430 small HCCs that were diagnosed through screening, were dichotomized according to a size of ≤ 3 cm or >3 cm maximum tumor diameter and compared for radiological and blood-test parameters.
There were 330 males and 100 females. A higher percent of females had smaller tumors. The majority of patients had single tumors, but 15% of those with larger tumors had portal vein thrombosis (PVT) compared to 5% of those with smaller tumors. Significant differences between the tumor-size groups included alpha-fetoprotein (AFP) values and platelet counts, with thrombocytopenia and elevated bilirubin levels being associated with smaller tumors. In comparing PVT-positive and PVT-negative patients, AFP levels and platelet counts were also significantly different between the 2 groups. A mean multinomial multiple logistic regression model was developed for maximum tumor diameter plus PVT.
The finding of larger tumors being associated with normal platelets and bilirubin levels in comparison to smaller tumors having thrombocytopenia reveals 2 different patterns of HCC presentation.
小肝癌和大肝癌的临床表型特征尚未得到很好的描述。
评估通过筛查诊断的小肝癌的特征。
将通过筛查诊断的 430 例小肝癌病例按肿瘤最大直径≤3cm 或>3cm 分为两组，并对其影像学和血液检测参数进行比较。
共有 330 名男性和 100 名女性，女性中较小肿瘤的比例较高。大多数患者为单发肿瘤，但与小肿瘤患者的 5%相比，大肿瘤患者中有 15%合并门静脉血栓形成（PVT）。肿瘤大小组之间的显著差异包括甲胎蛋白（AFP）值和血小板计数，血小板减少和胆红素水平升高与小肿瘤相关。在比较 PVT 阳性和 PVT 阴性患者时，两组间 AFP 水平和血小板计数也存在显著差异。建立了一个包含最大肿瘤直径和 PVT 的多项分类多变量逻辑回归模型。
与小肝癌相比，大肝癌患者的血小板和胆红素水平正常，而小肝癌患者则存在血小板减少，这揭示了两种不同的肝癌表现模式。
