Venepalli Neeta K, Modayil Mary V, Berg Stephanie A, Nair Tad D, Parepally Mayur, Rajaram Priyanka, Gaba Ron C, Bui James T, Huang Yue, Cotler Scott J
Neeta K Venepalli, Tad D Nair, Mayur Parepally, Priyanka Rajaram, Yue Huang, Department of Medicine, Section of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL 60612, United States.
World J Hepatol. 2017 Mar 8;9(7):391-400. doi: 10.4254/wjh.v9.i7.391.
To compare features of hepatocellular carcinoma (HCC) in Hispanics to those of African Americans and Whites.
Patients treated for HCC at an urban tertiary medical center from 2005 to 2011 were identified from a tumor registry. Data were collected retrospectively, including demographics, comorbidities, liver disease characteristics, tumor parameters, treatment, and survival (OS) outcomes. OS analyses were performed using Kaplan-Meier method.
One hundred and ninety-five patients with HCC were identified: 80.5% were male, and 22% were age 65 or older. Mean age at HCC diagnosis was 59.7 ± 9.8 years. Sixty-one point five percent of patients had Medicare or Medicaid; 4.1% were uninsured. Compared to African American (31.2%) and White (46.2%) patients, Hispanic patients (22.6%) were more likely to have diabetes ( = 0.0019), hyperlipidemia ( = 0.0001), nonalcoholic steatohepatitis (NASH) ( = 0.0021), end stage renal disease ( = 0.0057), and less likely to have hepatitis C virus ( < 0.0001) or a smoking history ( < 0.0001). Compared to African Americans, Hispanics were more likely to meet criteria for metabolic syndrome ( = 0.0491), had higher median MELD scores ( = 0.0159), ascites ( = 0.008), and encephalopathy ( = 0.0087). Hispanic patients with HCC had shorter OS than the other racial groups ( = 0.020), despite similarities in HCC parameters and treatment.
In conclusion, Hispanic patients with HCC have higher incidence of modifiable metabolic risk factors including NASH, and shorter OS than African American and White patients.
比较西班牙裔肝细胞癌(HCC)患者与非裔美国人和白人患者的特征。
从肿瘤登记处识别出2005年至2011年在城市三级医疗中心接受HCC治疗的患者。回顾性收集数据,包括人口统计学、合并症、肝脏疾病特征、肿瘤参数、治疗和生存(OS)结局。使用Kaplan-Meier方法进行OS分析。
共识别出195例HCC患者:80.5%为男性,22%年龄在65岁及以上。HCC诊断时的平均年龄为59.7±9.8岁。61.5%的患者有医疗保险或医疗补助;4.1%未参保。与非裔美国患者(31.2%)和白人患者(46.2%)相比,西班牙裔患者(22.6%)更易患糖尿病(P = 0.0019)、高脂血症(P = 0.0001)、非酒精性脂肪性肝炎(NASH)(P = 0.0021)、终末期肾病(P = 0.0057),且感染丙型肝炎病毒的可能性较小(P < 0.0001)或吸烟史的可能性较小(P < 0.0001)。与非裔美国人相比,西班牙裔更易符合代谢综合征标准(P = 0.0491),中位MELD评分更高(P = 0.0159),腹水发生率更高(P = 0.008),肝性脑病发生率更高(P = 0.0087)。尽管HCC参数和治疗相似,但西班牙裔HCC患者的OS比其他种族组短(P = 0.020)。
总之,西班牙裔HCC患者可改变的代谢危险因素(包括NASH)发生率较高,且OS比非裔美国人和白人患者短。