非酒精性脂肪性肝病患者肝细胞癌的临床病理特征
Clinicopathological features of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease.
作者信息
Mikuriya Yoshihiro, Tashiro Hirotaka, Kobayashi Tsuyoshi, Kuroda Shintaro, Abe Tomoyuki, Hashimoto Masakazu, Ohdan Hideki
机构信息
Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Hiroshima, 734-8551, Japan.
出版信息
Langenbecks Arch Surg. 2015 May;400(4):471-6. doi: 10.1007/s00423-015-1295-x. Epub 2015 Mar 6.
PURPOSE
The incidence of hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease (NAFLD) is increasing. However, the clinicopathological features of HCC in these patients are little known. Thus, we investigated the differences in the clinical and pathological characteristics of HCC between NAFLD patients and hepatitis-C virus (HCV) patients.
METHODS
Data from 21 HCC patients with NAFLD and 645 HCC patients with HCV who underwent curative hepatectomy were collected and analyzed. To overcome bias due to differences in the distribution of covariates between the two groups, propensity score matching was performed, and clinicopathological features and outcomes were compared.
RESULTS
In propensity score analysis, the rate of microscopic vascular invasion was significantly higher in the NAFLD group than in the HCV group (65 vs. 30%; P = 0.027). However, overall survival and disease-free survival did not differ between the two matched groups.
CONCLUSIONS
NAFLD may have permissive microenvironment for HCC progression.
目的
非酒精性脂肪性肝病（NAFLD）患者中肝细胞癌（HCC）的发病率正在上升。然而，这些患者中HCC的临床病理特征鲜为人知。因此，我们研究了NAFLD患者和丙型肝炎病毒（HCV）患者中HCC临床和病理特征的差异。
方法
收集并分析了21例接受根治性肝切除术的NAFLD-HCC患者和645例HCV-HCC患者的数据。为克服两组间协变量分布差异导致的偏倚，进行倾向评分匹配，并比较临床病理特征和预后。
结果
在倾向评分分析中，NAFLD组微血管侵犯的发生率显著高于HCV组（65%对30%；P = 0.027）。然而，两个匹配组之间的总生存期和无病生存期并无差异。
结论
NAFLD可能为HCC进展提供有利的微环境。
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