Kew M C, Popper H
Semin Liver Dis. 1984 May;4(2):136-46. doi: 10.1055/s-2008-1040653.
The precise nature of the relationship between cirrhosis and HCC remains to be elucidated. However, it seems likely that no single explanation will cover the various forms the association takes in different parts of the world. In the high HCC incidence regions of sub- Saharan Africa and the Far East, an etiology common to the two disorders, HBV and possibly other hepatitis viruses, seems to account for the majority of cases. The role of aflatoxin in these areas is uncertain because it appears not to cause cirrhosis in man. In populations in which HCC is uncommon, alcoholic cirrhosis is the most frequent association of HCC. There is no convincing evidence to support a shared etiology in this situation because alcohol has not thus far been proved to be directly oncogenic for the liver. Possibly, cirrhosis renders the hepatocytes more susceptible to environmental carcinogenic factors. The same explanation may apply to hemochromatosis. There is at present little evidence for the postulate that HCC is an inevitable consequence of the hyperplasia of cirrhosis.
肝硬化与肝癌之间关系的确切性质仍有待阐明。然而，似乎没有单一的解释能够涵盖在世界不同地区这种关联所呈现的各种形式。在撒哈拉以南非洲和远东地区肝癌高发区，这两种疾病共有的病因，即乙肝病毒以及可能的其他肝炎病毒，似乎是大多数病例的病因。黄曲霉毒素在这些地区的作用尚不确定，因为它似乎不会在人类中引发肝硬化。在肝癌不常见的人群中，酒精性肝硬化是与肝癌最常见的关联。在这种情况下，没有令人信服的证据支持共同病因的说法，因为到目前为止，酒精尚未被证明对肝脏具有直接致癌性。可能是肝硬化使肝细胞更容易受到环境致癌因素的影响。同样的解释可能适用于血色素沉着症。目前几乎没有证据支持肝癌是肝硬化增生必然结果这一假设。
