Division of Gastroenterological, Department of Surgery, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
BMC Gastroenterol. 2023 Jun 8;23(1):200. doi: 10.1186/s12876-023-02833-0.
The incidence of non-hepatitis B virus, non-hepatitis C virus hepatocellular carcinoma (non-B non-C-HCC) is increasing worldwide. We assessed the clinical characteristics and surgical outcomes of non-B non-C-HCC, versus hepatitis B (HBV-HCC) and hepatitis C (HCV-HCC).
Etiologies, fibrosis stages, and survival outcomes were analyzed of 789 consecutive patients who underwent surgery from 1990 to 2020 (HBV-HCC, n = 149; HCV-HCC, n = 424; non-B non-C-HCC, n = 216).
The incidence of hypertension and diabetes mellitus was significantly higher in patients with NON-B NON-C-HCC than in those with HBV-HCC and HCV-HCC. Significantly more advanced tumor stages were observed in patients with non-B non-C-HCC; however, better liver function and lower fibrosis stages were observed. Patients with non-B non-C-HCC had significantly worse 5-year overall survival than patients with HBV-HCC; overall survival was comparable between patients with non-B non-C-HCC and HCV-HCC. Patients with HCV-HCC had significantly worse 5-year recurrence-free survival than patients with HBV-HCC and non-B non-C-HCC. In patients with non-B non-C-HCC, overall survival was comparable among three periods (1990-2000, 2001-2010, and 2011-2020) despite significant improvement in patients with HBV-HCC and HCV-HCC.
The prognosis of non-B non-C-HCC was similar to that of HBV-HCC and HCV-HCC regardless of tumor progression at surgery. Patients with hypertension, diabetes mellitus, and dyslipidemia require careful systematic follow-up and treatment.
非乙型肝炎病毒、非丙型肝炎病毒肝细胞癌（非 B 非 C-HCC）的发病率在全球范围内呈上升趋势。我们评估了乙型肝炎（HBV-HCC）和丙型肝炎（HCV-HCC）与非乙型肝炎、非丙型肝炎 HCC （non-B non-C-HCC）的临床特征和手术结果。
分析了 1990 年至 2020 年期间连续接受手术的 789 例患者的病因、纤维化分期和生存结局（HBV-HCC，n=149；HCV-HCC，n=424；非 B 非 C-HCC，n=216）。
与 HBV-HCC 和 HCV-HCC 患者相比，NON-B NON-C-HCC 患者高血压和糖尿病的发病率显著更高。non-B non-C-HCC 患者的肿瘤分期明显更晚；然而，肝功能更好，纤维化分期更低。non-B non-C-HCC 患者的 5 年总生存率明显低于 HBV-HCC 患者；non-B non-C-HCC 患者与 HCV-HCC 患者的总生存率相当。HCV-HCC 患者的 5 年无复发生存率明显低于 HBV-HCC 和 non-B non-C-HCC 患者。在 non-B non-C-HCC 患者中，尽管 HBV-HCC 和 HCV-HCC 患者的情况明显改善，但在三个时期（1990-2000 年、2001-2010 年和 2011-2020 年）的总生存率相当。
无论手术时肿瘤进展如何，non-B non-C-HCC 的预后与 HBV-HCC 和 HCV-HCC 相似。高血压、糖尿病和血脂异常患者需要进行仔细的系统随访和治疗。
