Leung Christopher, Yeoh Sern Wei, Patrick Desmond, Ket Shara, Marion Kaye, Gow Paul, Angus Peter W
Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
World J Gastroenterol. 2015 Jan 28;21(4):1189-96. doi: 10.3748/wjg.v21.i4.1189.
To determine characteristics and prognostic predictors of patients with hepatocellular carcinoma (HCC) in association with non-alcoholic fatty liver disease (NAFLD).
We reviewed the records of all patients with NAFLD associated HCC between 2000 and 2012. Data collected included demographics; histology; presence or absence of cirrhosis, size and number of HCC, alpha-fetoprotein, body mass index (BMI), and the presence of diabetes, hypertension, or dyslipidaemia.
Fifty-four patients with NAFLD associated HCC were identified. Mean age was 64 years with 87% male. Fifteen percent (8/54) were not cirrhotic. 11%, 24% and 50% had a BMI of <25 kg/m2, 25-29 kg/m2 and ≥30 kg/m2 respectively. Fifty-nine percent were diabetic, 44% hypertensive and 26% hyperlipidaemic. Thirty-four percent of the patients had ≤1 of these risk factors. Non-cirrhotics had a significantly larger mean tumour diameter at diagnosis than cirrhotics (P=0.041). Multivariate analysis did not identify any other patient characteristics that predicted the size or number of HCC.
HCC can develop in NAFLD without cirrhosis. At diagnosis such tumours are larger than those in cirrhotics, conferring a poorer prognosis.
确定肝细胞癌（HCC）合并非酒精性脂肪性肝病（NAFLD）患者的特征及预后预测因素。
我们回顾了2000年至2012年间所有NAFLD相关HCC患者的记录。收集的数据包括人口统计学资料；组织学；有无肝硬化、HCC的大小和数量、甲胎蛋白、体重指数（BMI）以及糖尿病、高血压或血脂异常的情况。
共确定了54例NAFLD相关HCC患者。平均年龄为64岁，男性占87%。15%（8/54）无肝硬化。BMI<25kg/m²、25 - 29kg/m²和≥30kg/m²的患者分别占11%、24%和50%。59%患有糖尿病，44%患有高血压，26%患有血脂异常。34%的患者具有≤1种这些危险因素。非肝硬化患者诊断时的平均肿瘤直径显著大于肝硬化患者（P = 0.041）。多因素分析未发现其他可预测HCC大小或数量的患者特征。
NAFLD患者无肝硬化时也可发生HCC。诊断时此类肿瘤比肝硬化患者的肿瘤更大，预后更差。
