Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Liver Int. 2017 Jul;37(7):1042-1046. doi: 10.1111/liv.13423. Epub 2017 Apr 11.
BACKGROUND & AIMS: Hepatocellular adenoma is a benign liver tumour that may transform to hepatocellular carcinoma (HCC). We used data from Danish nationwide healthcare registries to investigate the incidence and prognosis of hepatocellular adenoma.
We included all patients with a hospital discharge diagnosis for benign liver tumour (ICD-10: D13.4) in 1997-2012 and a liver biopsy confirming the hepatocellular adenoma diagnosis. Follow-up began 1 year after adenoma diagnosis, to minimise the possibility that the tumour was a misdiagnosed HCC. All patients were age- and gender-matched with 50 random controls from the Danish population. We followed patients and controls with respect to HCC development, adenoma resection, and death without HCC (ie, death without having been diagnosed with HCC) through 2013. HCC diagnoses were identified in the Danish Cancer Registry.
We included 67 patients with hepatocellular adenoma, and 58 (87%) were women. The overall incidence rate of histologically verified hepatocellular adenoma in the Danish general population was 0.07 (95% CI: 0.06-0.09) per 100 000 population per year. Fifteen patients had their adenoma resected before follow-up began, leaving 52 patients for follow-up. Men with biopsy-confirmed hepatocellular adenoma had a 10-year cumulative HCC risk as high as 60.0% (95% CI: 15.3%-87.0%). All men who developed HCC were older than 50 years at adenoma diagnosis. By contrast, none of the 44 women in the follow-up analysis developed HCC.
Histologically verified hepatocellular adenoma is rare in Denmark. It is a minor concern for women, but men have a very high risk of progression to HCC.
肝细胞腺瘤是一种良性肝肿瘤，可能会转化为肝细胞癌（HCC）。我们利用丹麦全国医疗保健登记处的数据，调查了肝细胞腺瘤的发病率和预后。
我们纳入了 1997 年至 2012 年期间所有因良性肝肿瘤（ICD-10：D13.4）住院并经肝活检确诊为肝细胞腺瘤的患者。随访从腺瘤诊断后 1 年开始，以尽量减少肿瘤被误诊为 HCC 的可能性。所有患者均与丹麦人群中随机选择的 50 名年龄和性别相匹配的对照者进行匹配。我们通过 2013 年随访患者和对照者 HCC 发展、腺瘤切除以及无 HCC 死亡（即未被诊断为 HCC 的死亡）情况。HCC 诊断由丹麦癌症登记处确定。
我们纳入了 67 例肝细胞腺瘤患者，其中 58 例（87%）为女性。丹麦普通人群中经组织学证实的肝细胞腺瘤的总发病率为每年每 100 000 人 0.07（95%CI：0.06-0.09）。15 例患者在随访开始前接受了腺瘤切除术，其余 52 例患者接受了随访。经活检证实患有肝细胞腺瘤的男性 10 年 HCC 累积风险高达 60.0%（95%CI：15.3%-87.0%）。所有发生 HCC 的男性患者在诊断为腺瘤时均超过 50 岁。相比之下，在随访分析中，44 名女性均未发生 HCC。
在丹麦，经组织学证实的肝细胞腺瘤较为罕见。对女性而言，这是一个较小的担忧，但男性 HCC 的进展风险非常高。
