Marosi L, Ferenci P, Dragosics B, Kiss F, Pollak C, Minar E
Schweiz Med Wochenschr. 1983 Oct 29;113(43):1586-92.
The incidence of primary liver cancer (PLC) was assessed in 652 patients (429 male, 223 female) with liver cirrhosis. By the end of the study 64% of all patients had died. The autopsy rate was 65%. 138 patients (49%) died after acute gastrointestinal hemorrhage. PLC developed in 73 patients (11.3%). Histologically 67 cases were classified as hepatocellular, one as mixed hepatocellular-cholangiocellular, and 5 as cholangiocellular carcinoma. In 32 cases PLC was confirmed within a year of diagnosis of cirrhosis, while in the remaining 41 cases PLC developed 2 to 13 years later. At autopsy the frequency of PLC was twice as high in males (30%) as in females (15%) (p less than 0.025). This difference occurred in alcoholic and posthepatic cirrhosis but not in cryptogenetic cirrhosis. HBsAg was detected in 18.5% of male and 8.9% of female patients (p less than 0.01). Comparison of patients with and without PLC revealed no significant differences in the prevalence of HBsAg. These data indicate that PLC is common in Austrian patients with cirrhosis and represents 64% of all malignant tumors in this group. In view of the high HBsAg carrier rate and the prevalence of chronic alcoholism in patients with cirrhosis, it is suggested that both factors together lead to an increased risk of cirrhosis followed by an increased incidence of PLC. Survival curves show that that the prognosis of severe liver cirrhosis is the same as that of patients with malignant diseases. Therefore, it is important to detect these patients at an early stage of the disease.
对652例肝硬化患者（429例男性，223例女性）的原发性肝癌（PLC）发病率进行了评估。到研究结束时，所有患者中有64%死亡。尸检率为65%。138例患者（49%）死于急性胃肠道出血。73例患者（11.3%）发生了PLC。组织学上，67例被分类为肝细胞癌，1例为混合性肝细胞-胆管细胞癌，5例为胆管细胞癌。32例PLC在肝硬化诊断后1年内得到确诊，而其余41例PLC在2至13年后发生。尸检时，男性PLC的发生率（30%）是女性（15%）的两倍（p<0.025）。这种差异在酒精性和肝后性肝硬化中出现，但在隐源性肝硬化中未出现。18.5%的男性患者和8.9%的女性患者检测到HBsAg（p<0.01）。有PLC和无PLC患者的HBsAg患病率比较无显著差异。这些数据表明，PLC在奥地利肝硬化患者中很常见，占该组所有恶性肿瘤的64%。鉴于肝硬化患者中HBsAg携带率高和慢性酒精中毒患病率高，建议这两个因素共同导致肝硬化风险增加，随后PLC发病率增加。生存曲线显示，严重肝硬化患者的预后与恶性疾病患者相同。因此，在疾病早期检测出这些患者很重要。
