Takenaka K, Yamamoto K, Taketomi A, Itasaka H, Adachi E, Shirabe K, Nishizaki T, Yanaga K, Sugimachi K
Department of Surgery II, Kyushu University, Fukuoka, Japan.
Hepatology. 1995 Jul;22(1):20-4.
To assess the differences in the surgical results between patients with hepatitis B- and hepatitis C-related hepatocellular carcinoma (HCC), the operative outcomes of 30 patients with hepatitis B surface antigen (HBsAg)-positive (the B-HCC group) and 96 patients with hepatitis C antibody (HCVAb)-positive (the C-HCC group), who had undergone hepatic resection from 1989 to 1993, were compared. The mean age of the patients in the C-HCC group was higher than that in the B-HCC group (61.7 years vs. 57.0 years, P < .05). The C-HCC group demonstrated both a greater decrease in liver function and a larger enhancement of inflammatory changes in the liver under a pathological examination (the current rate of active hepatitis: 69% vs. 27%, P < .001). There was also a higher incidence of total postoperative complications in the C-HCC group (60% vs. 37%, P < .05); however, regarding each individual complication, the rate was similar between the two groups. Two of the six patients with postoperative hepatic failure in the C-HCC group died. The mortality rate in the C-HCC group was 2%, but no operative death was encountered in the B-HCC group. The crude survival and the disease-free survival rates at 5 years were similar, 61.8% and 46.2% in the B-HCC group and 52.8% and 23.2% in the C-HCC group, respectively. The patterns of recurrence were also similar in both groups. The pathological features of HCC were similar between the two groups. In conclusion, the surgical results between the two groups were almost identical.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估乙型肝炎和丙型肝炎相关肝细胞癌(HCC)患者手术结果的差异,对1989年至1993年期间接受肝切除术的30例乙型肝炎表面抗原(HBsAg)阳性患者(B-HCC组)和96例丙型肝炎抗体(HCVAb)阳性患者(C-HCC组)的手术结果进行了比较。C-HCC组患者的平均年龄高于B-HCC组(61.7岁对57.0岁,P <.05)。C-HCC组在病理检查中显示肝功能下降幅度更大,肝脏炎症变化增强更明显(当前活动性肝炎发生率:69%对27%,P <.001)。C-HCC组术后总并发症发生率也更高(60%对37%,P <.05);然而,就每种个体并发症而言,两组发生率相似。C-HCC组6例术后肝衰竭患者中有2例死亡。C-HCC组的死亡率为2%,但B-HCC组未发生手术死亡。5年时的粗生存率和无病生存率相似,B-HCC组分别为61.8%和46.2%,C-HCC组分别为52.8%和23.2%。两组的复发模式也相似。两组HCC的病理特征相似。总之,两组的手术结果几乎相同。(摘要截短至250字)