Goh Khean-Lee, Razlan Hamizah, Hartono Juanda Leo, Qua Choon-Seng, Yoong Boon-Koon, Koh Peng-Soon, Abdullah Basri Johan Jeet
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Dig Dis. 2015 Mar;16(3):152-8. doi: 10.1111/1751-2980.12223.
Hepatocellular carcinoma (HCC) is an important cancer in Malaysia. This study aimed to determine the epidemiological characteristics and clinical presentations of patients in a multiracial population consisting of three major Asian races: Malays, Chinese and Indians.
Consecutive patients with HCC were prospectively studied from 2006 to 2009. HCC was diagnosed principally on multiphasic computed tomography and magnetic resonance imaging scans of the liver. The tumor was staged according to the Barcelona Clinic Liver Cancer (BCLC) classification.
Altogether, 348 patients were diagnosed with HCC. There were 239 (68.7%) Chinese patients, 71 (20.4%) Malays and 38 (10.9%) Indians, with the median age of 62.5 years and the male to female ratio of 3.4:1. The predominant etiology in Malay and Chinese patients was hepatitis B virus infection (>60%) and in Indian patients was alcohol intake (26.3%) and cryptogenic cause (29.0%). Hepatitis C was seen in 18.3% of Malays, but less than 10% in Chinese and Indians. BCLC staging was: Stage A, 120 (34.5%); Stage B, 75 (21.6%); Stage C, 84 (24.1%); and Stage D, 69 (19.8%). A larger proportion of Indian than Chinese and Malays patients (44.7%) presented with stage D disease. Portal vein invasion was noted in 124 patients (35.6%) and extrahepatic metastases in 68 (19.5%). Surgical resection and radiofrequency ablation with curative intent was carried out in >90% of stage A patients and transarterial chemoembolization in 49.3% and 21.4% of stages B and C patients, respectively.
HCC is most common among Chinese, followed by Malays and Indians in Malaysia. The etiology of HCC shows a peculiar racial pattern.
肝细胞癌（HCC）是马来西亚一种重要的癌症。本研究旨在确定一个由马来人、华人、印度人这三个主要亚洲种族组成的多民族人群中患者的流行病学特征和临床表现。
对2006年至2009年连续的HCC患者进行前瞻性研究。HCC主要通过肝脏多期计算机断层扫描和磁共振成像扫描进行诊断。肿瘤根据巴塞罗那临床肝癌（BCLC）分类进行分期。
共有348例患者被诊断为HCC。其中华人患者239例（68.7%），马来人患者71例（20.4%），印度人患者38例（10.9%），中位年龄为62.5岁，男女比例为3.4:1。马来人和华人患者的主要病因是乙型肝炎病毒感染（>60%），而印度患者的主要病因是酒精摄入（26.3%）和隐源性病因（29.0%）。18.3%的马来人患者感染丙型肝炎，而华人及印度人患者中该比例低于10%。BCLC分期情况为：A期120例（34.5%）；B期75例（21.6%）；C期84例（24.1%）；D期69例（19.8%）。印度患者中表现为D期疾病的比例高于华人和马来人患者（44.7%）。124例患者（35.6%）出现门静脉侵犯，68例患者（19.5%）出现肝外转移。超过90%的A期患者接受了根治性手术切除和射频消融，B期和C期患者分别有49.3%和21.4%接受了经动脉化疗栓塞。
在马来西亚，HCC在华人中最为常见，其次是马来人和印度人。HCC的病因呈现出独特的种族模式。
