Kai Keita, Koga Hiroki, Aishima Shinichi, Kawaguchi Atsushi, Yamaji Koutaro, Ide Takao, Ueda Junji, Noshiro Hirokazu
Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
World J Gastroenterol. 2017 Feb 28;23(8):1397-1405. doi: 10.3748/wjg.v23.i8.1397.
To analyzed the correlation between smoking status and surgical outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC), and we investigated the patients' clinicopathological characteristics according to smoking status.
We retrospectively analyzed the consecutive cases of 83 NBNC-HCC patients who underwent curative surgical treatment for the primary lesion at Saga University Hospital between 1984 and December 2012. We collected information about possibly carcinogenic factors such as alcohol abuse, diabetes mellitus, obesity and smoking habit from medical records. Smoking habits were subcategorized as never, ex- and current smoker at the time of surgery. The diagnosis of non-alcoholic steatohepatitis (NASH) was based on both clinical information and pathological confirmation.
Alcohol abuse, diabetes mellitus, obesity and NASH had no significant effect on the surgical outcomes. Current smoking status was strongly correlated with both overall survival ( = 0.0058) and disease-specific survival ( = 0.0105) by multivariate analyses. Subset analyses revealed that the current smokers were significantly younger at the time of surgery ( = 0.0002) and more likely to abuse alcohol ( = 0.0188) and to have multiple tumors ( = 0.023).
Current smoking habit at the time of surgical treatment is a risk factor for poor long-term survival in NBNC-HCC patients. Current smokers tend to have multiple HCCs at a younger age than other patients.
分析非B非C型肝细胞癌(NBNC-HCC)患者吸烟状况与手术结局之间的相关性,并根据吸烟状况调查患者的临床病理特征。
我们回顾性分析了1984年至2012年12月期间在佐贺大学医院接受原发性病变根治性手术治疗的83例NBNC-HCC患者的连续病例。我们从病历中收集了有关可能的致癌因素的信息,如酗酒、糖尿病、肥胖和吸烟习惯。吸烟习惯在手术时被细分为从不吸烟、既往吸烟和当前吸烟。非酒精性脂肪性肝炎(NASH)的诊断基于临床信息和病理证实。
酗酒、糖尿病、肥胖和NASH对手术结局没有显著影响。多因素分析显示,当前吸烟状况与总生存期(P = 0.0058)和疾病特异性生存期(P = 0.0105)均密切相关。亚组分析显示,当前吸烟者在手术时明显更年轻(P = 0.0002),更有可能酗酒(P = 0.0188)和患有多发肿瘤(P = 0.023)。
手术治疗时的当前吸烟习惯是NBNC-HCC患者长期生存不良的危险因素。当前吸烟者比其他患者更容易在年轻时患有多发肝癌。