Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Laboratory of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Carcinogenesis. 2020 Nov 13;41(11):1576-1582. doi: 10.1093/carcin/bgaa024.
The difference of the patients bearing hepatocellular carcinoma (HCC) with and without cirrhosis at clinical level has not been completely determined. This study compared their differences in clinicopathological traits and prognostic factors for relapse-free survival (RFS) and overall survival (OS). Animal model was established to validate the result of clinical observation. As a result, 82 patients bearing HCC with no cirrhosis (HCC-NC) and 146 patients bearing HCC with cirrhosis (HCC-C) were included. HCC-NC exhibited shorter prothrombin time and higher plasma albumin than HCC-C. In HCC-NC, satellite nodule was an independent risk factor for OS, and high γ-glutamyl transpeptidase was an independent risk factor for RFS. In HCC-C, female sex was an independent risk factor for OS. Stratified analysis showed the OS and RFS of HCC-NC were better than HCC-C in conditions like without cancer embolus (in the portal vein or bile duct), without lymphadenopathy in hepatic portal, without satellite nodule and with small or high-differentiated tumor. Animal model analysis showed HCC-NC had a higher liver/body weight ratio, less tumor count and smaller max tumor volume than HCC-C. In conclusion, clinicopathological traits and risk factors influencing postoperative OS and RFS differed between patients with HCC-C and HCC-NC.
在临床水平上,患有肝细胞癌(HCC)伴或不伴肝硬化的患者之间存在差异尚未完全确定。本研究比较了他们在临床病理特征和无复发生存(RFS)和总生存(OS)的预后因素方面的差异。建立了动物模型来验证临床观察的结果。结果,纳入了 82 例无肝硬化的 HCC 患者(HCC-NC)和 146 例伴肝硬化的 HCC 患者(HCC-C)。HCC-NC 的凝血酶原时间较短,血浆白蛋白水平较高。在 HCC-NC 中,卫星结节是 OS 的独立危险因素,γ-谷氨酰转肽酶高是 RFS 的独立危险因素。在 HCC-C 中,女性是 OS 的独立危险因素。分层分析显示,在无癌栓(门静脉或胆管内)、肝门部无淋巴结病、无卫星结节且肿瘤较小或高分化的情况下,HCC-NC 的 OS 和 RFS 优于 HCC-C。动物模型分析显示,HCC-NC 的肝/体重比高于 HCC-C,肿瘤数量较少,最大肿瘤体积较小。总之,HCC-C 和 HCC-NC 患者术后 OS 和 RFS 的临床病理特征和影响预后的因素不同。