Hwang S J, Lee S D, Wu J C, Chang C F, Lu C L, Tsay S H, Lo K J
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 May;53(5):262-9.
Hepatocellular carcinoma (HCC) is a common malignancy in southeast Asia and sub-Saharan Africa. During its clinical course, patients may manifest a variety of paraneoplastic syndromes, including erythrocytosis. However, there are few reports on the clinical and biochemical characteristics of HCC patients who manifest erythrocytosis. The purpose of this study is to evaluate the incidence of erythrocytosis in a large series of the Chinese patients with HCC, and to investigate the association of erythrocytosis with tumor volume and with serum levels of alpha-fetoprotein (AFP) and erythropoietin.
Among 792 Chinese HCC patients who were seen during a 3-year period, we identified HCC patients with erythrocytosis as those with hemoglobin levels greater than 16.7 gm/dL (two standard deviations above the mean hemoglobin level of matched normal controls). The tumor size and serum levels of AFP and erythropoietin were evaluated in HCC patients with erythrocytosis to compare with HCC patients without erythrocytosis.
20 (2.5%) of 792 Chinese HCC patients presented with erythrocytosis. Nineteen of these 20 HCC patients were found to have either bi-lobar tumor involvement or a large tumor mass confined to one lobe of the liver. The estimated mean tumor volume of HCC patients with erythrocytosis was 50% of whole liver. When compared with HCC patients without erythrocytosis, the 20 HCC patients with high hemoglobin levels had significantly higher serum levels of AFP and erythropoietin (356,343 +/- 145,807 vs. 16,881 +/- 10,425 ng/mL, 135 +/- 45 vs. 25 +/- 4 mU/mL, respectively, p < 0.01).
Base on our findings, detection of erythrocytosis in a patient with HCC would indicate the presence of a large tumor burden, and high serum levels of both AFP and erythropoietin should be associated with this paraneoplastic syndrome.
肝细胞癌（HCC）在东南亚和撒哈拉以南非洲地区是一种常见的恶性肿瘤。在其临床病程中，患者可能会出现多种副肿瘤综合征，包括红细胞增多症。然而，关于出现红细胞增多症的HCC患者的临床和生化特征的报道较少。本研究的目的是评估大量中国HCC患者中红细胞增多症的发生率，并探讨红细胞增多症与肿瘤体积以及血清甲胎蛋白（AFP）和促红细胞生成素水平之间的关联。
在3年期间就诊的792例中国HCC患者中，我们将血红蛋白水平高于16.7 gm/dL（比匹配的正常对照的平均血红蛋白水平高两个标准差）的HCC患者确定为患有红细胞增多症的患者。对患有红细胞增多症的HCC患者的肿瘤大小以及AFP和促红细胞生成素的血清水平进行评估，以与未患红细胞增多症的HCC患者进行比较。
792例中国HCC患者中有20例（2.5%）出现红细胞增多症。这20例HCC患者中有19例被发现有双叶肿瘤累及或局限于肝脏一叶的大肿瘤块。患有红细胞增多症的HCC患者的估计平均肿瘤体积为全肝的50%。与未患红细胞增多症的HCC患者相比，20例血红蛋白水平高的HCC患者的血清AFP和促红细胞生成素水平显著更高（分别为356,343±145,807 vs. 16,881±10,425 ng/mL，135±）。
