Chikhi Yazid, Cheraitia Salima, Ould Gougam Rachid, Lounes Fadila, Zemmouchi Chahrazed, Belal Nassila, Bendaoud Maroua, Ait Younes Sonia, Bensalem Aicha, Berkane Saadi, Asselah Hocine, Pineau Pascal, Lahcene Mustapha
Department of Internal medicine and Gastroenterology, EPH Bologhine, Algiers, Algeria.
Department of Radiology, Hôpital Central de l'Armée, Ain Naadja, Algiers, Algeria.
Gastrointest Tumors. 2019 Oct;6(3-4):122-136. doi: 10.1159/000501453. Epub 2019 Aug 30.
Hepatocellular carcinoma (HCC) represents a worrying public health problem in North Africa and particularly in Egypt. The situation is unclear in western North Africa where HCC has been rarely submitted to careful scrutiny. We decided to analyze demographic, biochemical, virological, and clinical data of a series of HCC from Algerian patients to establish the landscape of this tumor in the country. In the present work, we described 337 cases of primary liver cancer from Bologhine Hospital in Algiers, the capital of Algeria. The mean age of patients was 63.8 ± 11.4 years with a male:female sex ratio of 1.5. The most prevalent risk factors were hepatitis C, hepatitis B, and metabolic pathologies (type 2 diabetes and obesity). The mean BMI was 25.6 ± 4.7 at tumor diagnosis. A strong duality of risk factors and tumor presentation between male and female patients was apparent. Women tended to be older (mean 65.4 vs. 62.7 years, = 0.039) and either seropositive for anti-HCV (60.0 vs. 41.6%, = 0.0018) resulting primarily from tattoos and/or scarification (47.2 vs. 25.7%, = 1.0 × 10) or more often affected by metabolic disorders (mean BMI 26.1 ± 0.7 vs. 25.1 ± 0.5, = 0.0248) commonly associated with personal antecedents of cholecystectomy (21.2 vs. 5.8%, = 4.4 × 10). By contrast, men were younger, poorer survivors (mean 9.3 vs. 13.3 months, = 0.005), more frequently HBsAg carriers (27.8 vs. 10.5%, = 4.8 × 10), and more exposed to lifestyle risk factors such as smoking (39.4 vs. 3.0%, = 3.9 × 10) or alcohol use (19.1 vs. 0.7%, 1.5 × 10). Finally, geographic disparities throughout Algeria were reminiscent of the situation of chronic hepatitis C in the country. A significant excess of cases originated from the region of Batna, Eastern Algeria, already known for its high rate of hepatitis C. Our results suggest that due to culture or sex-dependent biological differences, the tumor process affecting the liver is drastically different between sexes in Algeria.
肝细胞癌（HCC）在北非尤其是埃及是一个令人担忧的公共卫生问题。在北非西部，情况尚不明朗，因为那里的肝细胞癌很少受到仔细审查。我们决定分析一系列阿尔及利亚患者肝细胞癌的人口统计学、生化、病毒学和临床数据，以了解该国这种肿瘤的情况。在本研究中，我们描述了来自阿尔及利亚首都阿尔及尔博洛希内医院的337例原发性肝癌病例。患者的平均年龄为63.8±11.4岁，男女比例为1.5。最常见的危险因素是丙型肝炎、乙型肝炎和代谢性疾病（2型糖尿病和肥胖）。肿瘤诊断时的平均体重指数为25.6±4.7。男性和女性患者在危险因素和肿瘤表现方面存在明显的二元性。女性往往年龄较大（平均65.4岁对62.7岁，P = 0.039），抗丙型肝炎病毒血清阳性率较高（60.0%对41.6%，P = 0.0018），主要是由于纹身和/或划痕（47.2%对25.7%，P = 1.0×10），或者更常受代谢紊乱影响（平均体重指数26.1±0.7对25.1±0.5，P = 0.0248），这通常与胆囊切除术个人史有关（21.2%对5.8%，P = 4.4×10）。相比之下，男性较年轻，生存率较低（平均9.3个月对13.3个月，P = 0.005），乙肝表面抗原携带者更频繁（27.8%对10.5%，P = 4.8×10），并且更多地暴露于吸烟（39.4%对3.0%，P = 3.9×10）或饮酒（19.1%对0.7%，1.5×10）等生活方式危险因素。最后，阿尔及利亚各地的地理差异让人想起该国慢性丙型肝炎的情况。显著过多的病例来自阿尔及利亚东部的巴特纳地区，该地区已因丙型肝炎高发病率而闻名。我们的结果表明，由于文化或性别依赖性生物学差异，阿尔及利亚男女之间影响肝脏的肿瘤进程截然不同。
