Departments of aHCC Biology bEpidemiology, IRCCS S. de Bellis, National Institute for Digestive Diseases, Castellana Grotte (BA), Italy.
Eur J Gastroenterol Hepatol. 2014 Jan;26(1):101-8. doi: 10.1097/MEG.0b013e3283644c49.
Massive hepatocellular carcinomas (HCCs) are uncommon and poorly characterized.
To characterize a large cohort of HCC patients with massive tumors, with documented baseline characteristics and survival data.
Records were examined of a cohort of 344 biopsy-proven and randomly presenting unresectable HCC patients with tumors of at least 10 cm diameter (massive), which were analyzed for their clinical characteristics and survival.
Massive HCC patients were significantly different from others, in having less severe cirrhosis and higher blood platelet counts, α-fetoprotein (AFP), alkaline phosphatase (ALKP), and γ-glutamyl transpeptidase (GGTP) levels. Platelets, ALKP, and GGTP correlated with tumor size. Within massive HCCs, ALKP levels related to tumor number, whereas platelet counts related to tumor size. AFP and GGTP related to neither. All four parameters related to survival. A multivariate Cox proportional hazard model showed that ALKP and AFP were significant for overall survival. Survival of massive tumors was not significantly worse than for other larger tumors.
Massive HCCs were characterized by high blood platelets, AFP, ALKP, and GGTP levels. AFP levels were important for survival, but did not directly relate to tumor size or number, suggesting that AFP represents some other property of massive HCC biology. Patients with massive HCC should thus be considered for active therapeutic intervention, just as for other sizes of HCC.
巨块型肝癌（HCC）较为少见且特征不明显。
对大量巨块型 HCC 患者的基线特征和生存数据进行描述。
分析了 344 例经活检证实且随机出现的无法切除的 HCC 患者的记录，这些患者的肿瘤直径至少为 10cm（巨块型），对其临床特征和生存情况进行了分析。
与其他 HCC 患者相比，巨块型 HCC 患者的肝硬化程度较轻，血小板计数、甲胎蛋白（AFP）、碱性磷酸酶（ALKP）和γ-谷氨酰转肽酶（GGTP）水平较高。血小板、ALKP 和 GGTP 与肿瘤大小相关。在巨块型 HCC 中，ALKP 水平与肿瘤数量相关，而血小板计数与肿瘤大小相关。AFP 和 GGTP 均与两者无关。所有四个参数均与生存相关。多变量 Cox 比例风险模型显示，ALKP 和 AFP 对总生存有显著影响。巨块型肿瘤的生存并未明显差于其他更大的肿瘤。
巨块型 HCC 具有较高的血小板、AFP、ALKP 和 GGTP 水平。AFP 水平对生存很重要，但与肿瘤大小或数量没有直接关系，这表明 AFP 代表了巨块型 HCC 生物学的其他一些特性。因此，应考虑对巨块型 HCC 患者进行积极的治疗干预，就像对其他大小的 HCC 患者一样。
