肝细胞癌患者与年龄相关的不同临床病理特征。
Age-related, different clinicopathologic features of hepatocellular carcinoma patients.
作者信息
Namieno T, Kawata A, Sato N, Kondo Y, Uchino J
机构信息
Department of Surgery, Sapporo-Kosei General Hospital, Japan.
出版信息
Ann Surg. 1995 Mar;221(3):308-14. doi: 10.1097/00000658-199503000-00014.
OBJECTIVE
The authors attempted to clarify the clinicopathologic differences of hepatocellular carcinoma (HCC) patients, according to age distribution, and to investigate whether these differences contribute a certain hepatocarcinogenesis.
SUMMARY BACKGROUND DATA
Hepatitis-associated viruses causing HCC have been investigated, and the infection of the viruses and etiologically, the peak age of the disease vary according to geographic barriers. However, a correlation between clinicopathologic differences and the age distribution of the patients is not well understood.
METHODS
The authors reviewed their institutional experience from 1978 to 1990 in treating 428 patients with HCC. The carrier rate for hepatitis B surface antigen (HBsAg), the frequency of occurrence of high serum alpha-fetoprotein (AFP) of 2000 ng/mL, the degree of liver damage represented by the retention rate of indocyanine green dye at 15 minutes (ICGR15), and the incidence of accompanying liver cirrhosis were investigated and compared in each decade of age.
RESULTS
The HBsAg carrier rate and the frequency of high serum AFP values were significantly prominent in the younger patients (20-49 yrs). The degree of liver damage and the incidence of liver cirrhosis were prominent in the elderly patients (older than 70 yrs) or the middle-aged patients (50-69 yrs); however, these four values in the middle-aged patients were intermediate with respect to those observed in the other two age groups. In addition, there was a positive correlation between the HBsAg carrier rate and the frequency of high serum AFP values or between the degree of liver damage represented by ICGR15 and the incidence of liver cirrhosis, showing that the former correlation was inversely related to the latter.
CONCLUSIONS
The authors' study indicates that there are age-related differences of clinicopathologic features in HCC patients, suggesting that there are different steps or mechanisms of hepatocarcinogenesis according to the patient's age-distribution.
目的
作者试图根据年龄分布阐明肝细胞癌（HCC）患者的临床病理差异，并研究这些差异是否对某种肝癌发生机制有影响。
总结背景资料
已对导致HCC的肝炎相关病毒进行了研究，病毒感染以及从病因学角度来看，该病的发病高峰年龄因地理屏障而有所不同。然而，临床病理差异与患者年龄分布之间的相关性尚未得到充分理解。
方法
作者回顾了他们在1978年至1990年期间治疗428例HCC患者的机构经验。调查并比较了各年龄段患者的乙肝表面抗原（HBsAg）携带率、血清甲胎蛋白（AFP）≥2000 ng/mL的出现频率、以15分钟靛氰绿滞留率（ICGR15）表示的肝损伤程度以及伴发肝硬化的发生率。
结果
HBsAg携带率和高血清AFP值的频率在较年轻患者（20 - 49岁）中显著更高。肝损伤程度和肝硬化发生率在老年患者（70岁以上）或中年患者（50 - 69岁）中更为突出；然而，中年患者的这四项指标介于其他两个年龄组之间。此外，HBsAg携带率与高血清AFP值的频率之间或ICGR15所代表的肝损伤程度与肝硬化发生率之间存在正相关，表明前一种相关性与后一种呈负相关。
结论
作者的研究表明，HCC患者存在与年龄相关的临床病理特征差异，提示根据患者年龄分布存在不同的肝癌发生步骤或机制。
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