Lin Shu-Hsien, Eng Hock-Liew, Liu Yueh-Wei, Lin Chih-Che, Yong Chee-Chien, Wang Chih-Chi, Chen Chao-Long, Kuo Fang-Ying, Cheng Yu-Fan, Wang Jing-Houng, Yen Yi-Hao, Liu Ting-Ting, Li Wei-Feng, Chen Chien-Hung
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Am J Surg. 2022 Feb;223(2):339-345. doi: 10.1016/j.amjsurg.2021.03.065. Epub 2021 Apr 5.
Large well-differentiated hepatocellular carcinoma (HCC) ≥ 3 cm (defined as atypical HCC) is uncommon. We evaluated the characteristics and outcomes of atypical HCC patients underwent liver resection (LR).
This retrospective study enrolled patients who underwent LR for HCC from 2007 to 2017. Patient characteristics and overall survival (OS) were compared between patients with atypical HCC and patients with typical HCC (moderate-to-undifferentiated HCC ≥ 3 cm).
Among 598 patients, 51 (8.5%) had atypical HCC. Patients with atypical HCC had higher rates of non-hepatitis B or C infections (p = 0.02) and American Joint Committee on Cancer T1 pathology (p < 0.001), a lower rate of alpha-fetoprotein >20 ng/ml (p < 0.001) and a longer OS (p < 0.001) than those with typical HCC. Multivariate analysis showed that atypical HCC was associated with OS (HR = 0.50, 95% CI = 0.27-0.91, p = 0.02).
Patients with atypical HCC have a higher rate of non-hepatitis B or C infections and a lower rate of aggressive tumor biologic behavior. Atypical HCC is an independent predictor of OS.
直径≥3cm的大的高分化肝细胞癌（HCC）（定义为非典型HCC）并不常见。我们评估了接受肝切除术（LR）的非典型HCC患者的特征和预后。
这项回顾性研究纳入了2007年至2017年因HCC接受LR的患者。比较了非典型HCC患者和典型HCC（中度至低分化HCC≥3cm）患者的特征和总生存期（OS）。
在598例患者中，51例（8.5%）患有非典型HCC。与典型HCC患者相比，非典型HCC患者非乙型或丙型肝炎感染率更高（p = 0.02），美国癌症联合委员会T1期病理比例更高（p < 0.001），甲胎蛋白>20 ng/ml的比例更低（p < 0.001），OS更长（p < 0.001）。多因素分析显示，非典型HCC与OS相关（HR = 0.50，95%CI = 0.27 - 0.91，p = 0.02）。
非典型HCC患者非乙型或丙型肝炎感染率更高，侵袭性肿瘤生物学行为发生率更低。非典型HCC是OS的独立预测因素。
