Division of Gastrohepatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Division of Gastrohepatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ; Gastrohepatology unit, Rajavej Chiang Mai Hospital, Chiang Mai, Thailand.
J Clin Transl Hepatol. 2015 Sep 28;3(3):182-8. doi: 10.14218/JCTH.2015.00025. Epub 2015 Sep 15.
Hepatocellular carcinoma (HCC) is the most common type of liver cancer worldwide. The incidence of HCC is on the rise in Thailand, where it has become the most common malignancy in males and the third most common in females. Here, we review some of the risk factors that have contributed to this increase in HCC incidence in the Thai population. Hepatitis B virus (HBV) is the main etiologic risk factor for HCC, followed by hepatitis C virus (HCV). Patients with HBV genotype C have a higher positive rate of hepatitis B early antigen (HBeAg) and progress to cirrhosis and HCC earlier than genotype B. For HCV patients, 16% developed HCC associated cirrhosis by year 5 after diagnosis, and the cumulative risk for death from HCC at year 10 was 60%. Dietary exposure to the fungal hepatocarcinogen aflatoxin B1 has been shown to interact synergistically with HBV infection to increase the risk of early onset HCC. Chronic alcohol abuse remains an important risk factor for malignant transformation of hepatocytes, frequently in association with alcohol-induced cirrhosis. In recent years, obesity and metabolic syndrome have markedly increased the incidence of HCC and are important causes of HCC in some resource-rich regions.
肝细胞癌 (HCC) 是全球最常见的肝癌类型。在泰国，HCC 的发病率呈上升趋势，在男性中已成为最常见的恶性肿瘤，在女性中排名第三。在此，我们回顾了一些导致泰国人群 HCC 发病率上升的风险因素。乙型肝炎病毒 (HBV) 是 HCC 的主要病因危险因素，其次是丙型肝炎病毒 (HCV)。HBV 基因型 C 的患者 HBeAg 阳性率更高，进展为肝硬化和 HCC 的时间也早于基因型 B。对于 HCV 患者，诊断后 5 年内有 16%发展为 HCC 相关肝硬化，10 年内 HCC 死亡的累积风险为 60%。真菌性肝癌致癌物黄曲霉毒素 B1 的饮食暴露已被证明与 HBV 感染具有协同作用，增加了 HCC 早期发病的风险。慢性酒精滥用仍然是肝细胞恶性转化的重要危险因素，常与酒精性肝硬化有关。近年来，肥胖和代谢综合征显著增加了 HCC 的发病率，是一些资源丰富地区 HCC 的重要病因。
