Han Deng, Zhang Zhi-Yu, Deng Jin-Yan, Du Hong-Bo
Division of Gastroenterology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
Beijing University of Chinese Medicine, Beijing 100105, China.
World J Gastrointest Oncol. 2024 Jul 15;16(7):2999-3010. doi: 10.4251/wjgo.v16.i7.2999.
Investigating the impact of race on the clinicopathologic characteristics and prognosis of hepatic malignant tumors represents a complex and significant area of research. Notably, distinct differences exist among various racial groups in terms of the clinical manifestations, pathologic features, and prognosis of hepatic malignant tumors.
To explore the effect of race on clinicopathologic features and prognosis of hepatic malignancies.
Data from patients with hepatic malignancies diagnosed between 2000 and 2019 were collected from the Surveillance, Epidemiology, and End Results database and statistically analyzed.
This study included 123558 patients with hepatic malignant tumors, among whom 21078 (17.06%) were Asian, 14810 (11.99%) were Black, and 87670 (70.95%) were white. The median survival times for patients with hepatic malignant tumors of different races were 12.56, 7.70, and 9.35 months for Asian patients, Black patients, and white patients, respectively. The 3-year survival rates for Asian, Black, and white patients were 29%, 19%, and 21%, respectively, and the 5-year survival rates were 22%, 13%, and 15%, respectively. The Kruskal-Wallis test indicated a significant difference in the survival time of patients with hepatic malignant tumors between different races ( < 0.001). Univariate analysis revealed gender disparities in the prognosis among different ethnic groups (Asian: > 0.05; Black: < 0.001; White: < 0.05). Among Black patients, the prognosis was less affected by the degree of hepatic fibrosis than among Asian patients and white patients (Black patients: < 0.05; Asian patients: < 0.001; White patients: < 0.001). Significant differences were observed in the median survival time among patients with hepatic neuroendocrine tumors and hepatoblastomas during pathologic staging between races. Tumor number was inversely related to the prognosis. Cox regression analyses revealed that T stage, M stage, surgery, chemotherapy, alpha-fetoprotein, and tumor size independently influenced prognosis. Age was a specific independent prognostic factor for white patients. Among the tumor stages, N stage is a self-reliant prognostic element specific to white patients. Conversely, radiotherapy and liver fibrosis were not self-reliant prognostic factors for Black patients. Income alone did not independently influence the prognosis of Asian patients.
The prognosis of hepatic malignant tumors is better among Asian patients than among Black patients. The prognosis of hepatic malignant tumors among white patients is affected by multiple factors, including age and N stage.
研究种族对肝脏恶性肿瘤临床病理特征及预后的影响是一个复杂且重要的研究领域。值得注意的是，不同种族群体在肝脏恶性肿瘤的临床表现、病理特征及预后方面存在明显差异。
探讨种族对肝脏恶性肿瘤临床病理特征及预后的影响。
收集2000年至2019年诊断为肝脏恶性肿瘤患者的数据，来自监测、流行病学和最终结果数据库，并进行统计分析。
本研究纳入123558例肝脏恶性肿瘤患者，其中亚洲人21078例（17.06%），黑人14810例（11.99%），白人87670例（70.95%）。不同种族肝脏恶性肿瘤患者的中位生存时间分别为：亚洲患者12.56个月，黑人患者7.70个月，白人患者9.35个月。亚洲、黑人和白人患者的3年生存率分别为29%、19%和21%，5年生存率分别为22%、13%和15%。Kruskal-Wallis检验表明不同种族肝脏恶性肿瘤患者的生存时间存在显著差异（<0.001）。单因素分析显示不同种族群体预后存在性别差异（亚洲人：>0.05；黑人：<0.001；白人：<0.05）。在黑人患者中，肝纤维化程度对预后的影响小于亚洲患者和白人患者（黑人患者：<0.05；亚洲患者：<0.001；白人患者：<0.001）。不同种族间肝脏神经内分泌肿瘤和肝母细胞瘤患者病理分期时的中位生存时间存在显著差异。肿瘤数量与预后呈负相关。Cox回归分析显示，T分期、M分期、手术、化疗、甲胎蛋白和肿瘤大小独立影响预后。年龄是白人患者特有的独立预后因素。在肿瘤分期中，N分期是白人患者特有的独立预后因素。相反，放疗和肝纤维化不是黑人患者的独立预后因素。单独的收入并未独立影响亚洲患者的预后。
亚洲患者肝脏恶性肿瘤的预后优于黑人患者。白人患者肝脏恶性肿瘤的预后受多种因素影响，包括年龄和N分期。
