Herr W, Gerken G, Poralla T, Immenschuh S, Schirmacher P, Steegmüller K W, Schwickert H, Meyer zum Büschenfelde K H
I. Medizinische Klinik und Poliklinik, Johannes Gutenberg-Universität Mainz.
Clin Investig. 1993 Jan;71(1):49-53. doi: 10.1007/BF00210964.
The case of a 71-year-old man with a primary hepatocellular carcinoma in a non-cirrhotic liver is reported. There were no risk factors of hepatocellular carcinoma (HCC)-like liver cirrhosis, alcohol drinking, tobacco smoking, exposure to vinyl chloride, thorotrast, aflatoxin or alpha 1-antitrypsin deficiency. Serologically, the patient was positive for antibodies to the hepatitis B virus (anti-HBc, anti-HBs) and for anti-hepatitis C virus (HCV) antibodies. Virologically, positive and negative strands of HCV RNA could be detected in the patient's serum and tumorous liver tissue by reverse transcription polymerase chain reaction as a sign of persistent HCV replication. Histologically, the HCC was completely surrounded by liver tissue which showed the signs of nodular regenerative hyperplasia. Indeed, the mechanism of hepatocarcinogenesis remains to be clarified. However, this case supports the observation that HCC may also develop in patients with HCV infection without preexisting liver cirrhosis.
报告了一例71岁男性原发性肝细胞癌患者，其肝脏无肝硬化。该患者没有肝细胞癌（HCC）样肝硬化、饮酒、吸烟、接触氯乙烯、钍造影剂、黄曲霉毒素或α1-抗胰蛋白酶缺乏等危险因素。血清学检查显示，该患者乙肝病毒抗体（抗-HBc、抗-HBs）和抗丙型肝炎病毒（HCV）抗体均为阳性。病毒学检查发现，通过逆转录聚合酶链反应可在患者血清和肿瘤肝组织中检测到HCV RNA的正负链，这表明HCV持续复制。组织学检查显示，HCC完全被肝组织包围，肝组织呈现结节状再生性增生的迹象。事实上，肝癌发生的机制仍有待阐明。然而，该病例支持了HCV感染且无肝硬化的患者也可能发生HCC这一观察结果。
