Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Liver Transplantation Center, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
PLoS One. 2021 Jan 13;16(1):e0244939. doi: 10.1371/journal.pone.0244939. eCollection 2021.
BACKGROUND/AIMS: A recent study from the United States reported that nearly 12% of hepatocellular carcinomas (HCCs) occurred in patients without cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common liver disease in these patients. We aim to evaluate the characteristics, etiologies, and outcomes of cases of non-cirrhotic HCC in East Asia, where there is a higher prevalence of hepatitis B virus (HBV)-associated non-cirrhotic HCC.
This retrospective study consecutively enrolled de novo HCC patients managed at our institution from 2011 to 2017. The presence of cirrhosis was assessed by histology; if histology was not available, it was assessed by image study.
2055 patients with HCC were enrolled in this study. Among them, 529 (25.7%) were non-cirrhotic. The non-cirrhotic patients were younger (60.9 vs. 62.5 years, p = 0.006), included a greater proportion of males (78.1% vs. 71.3%, p = 0.002), and had a lower body mass index (24.3 vs. 25.3 kg/m2, p<0.001) than the cirrhotic patients. Among the non-cirrhotic patients, HBV was the most common liver disease (49.0%). The patients with non-cirrhotic HCC had larger tumors (5.9 vs. 4.7 cm, p<0.001), underwent liver resection at a higher rate (66.0% vs. 17.4%, p<0.001), and had better overall survival than the cirrhotic HCC patients (median 5.67 vs. 2.83 years, p<0.001).
Nearly 26% of the HCCs occurred in patients without cirrhosis. HBV was the most common liver disease in these patients, and the survival was better in the non-cirrhotic patients than the cirrhotic patients.
背景/目的： 美国的一项研究报告称，近 12%的肝细胞癌（HCC）发生在无肝硬化的患者中。这些患者中最常见的肝脏疾病是非酒精性脂肪性肝病（NAFLD）。我们旨在评估东亚非肝硬化 HCC 病例的特征、病因和结局，在东亚，乙型肝炎病毒（HBV）相关的非肝硬化 HCC 更为普遍。
这项回顾性研究连续纳入了 2011 年至 2017 年在我院接受治疗的初发 HCC 患者。通过组织学评估肝硬化的存在；如果没有组织学检查，则通过影像学检查进行评估。
本研究共纳入 2055 例 HCC 患者。其中，529 例（25.7%）为非肝硬化。非肝硬化患者更年轻（60.9 岁比 62.5 岁，p=0.006），男性比例更高（78.1%比 71.3%，p=0.002），体重指数更低（24.3 千克/平方米比 25.3 千克/平方米，p<0.001）。在非肝硬化患者中，HBV 是最常见的肝脏疾病（49.0%）。非肝硬化 HCC 患者的肿瘤更大（5.9 厘米比 4.7 厘米，p<0.001），接受肝切除术的比例更高（66.0%比 17.4%，p<0.001），总体生存率优于肝硬化 HCC 患者（中位生存时间 5.67 年比 2.83 年，p<0.001）。
近 26%的 HCC 发生在无肝硬化的患者中。这些患者中最常见的肝脏疾病是 HBV，而非肝硬化患者的生存情况优于肝硬化患者。
