Shuto T, Hirohashi K, Kubo S, Tsukamoto T, Yamamoto T, Wakasa K, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Japan.
Hepatogastroenterology. 1998 Sep-Oct;45(23):1722-5.
BACKGROUND/AIMS: The purpose of this study was to clarify the clinicopathologic differences of hepatocellular carcinoma associated with the hepatitis B versus the hepatitis C virus.
One hundred and sixty-eight patients with resected hepatocellular carcinoma were tested for viral hepatitis. Ten (6%) had both the hepatitis B surface antigen and antibodies to the hepatitis C virus. Thirty-three (20%) had neither marker. Sixteen (9%) had only the hepatitis B surface antigen (group B), and 109 (65%) had only antibodies to the hepatitis C virus (group C). We compared groups B and C clinicopathologically.
The mean tumor diameter was larger in group B than in group C (6.3 cm vs 3.4 cm), while group B patients were younger than group C (48 yrs vs 62 yrs, p<0.0001). Poor liver function, histologic cirrhosis and chronic active hepatitis were frequently found in group C. The 1- and 2-year tumor-free survival rates following surgery in group B were 67% and 33%, and those in group C were 73% and 49%. The 1-, 2-, and 3-year survival rates following surgery in group B were 78%, 68%, and 0%, while those in group C were 92%, 83%, and 76% (p=0.0189).
Hepatocellular carcinoma with concomitant hepatitis B viral infection was found to present as larger tumors in younger patients with less severe liver dysfunction. Hepatocellular carcinoma with concomitant hepatitis C viral infection was often detected in follow-up studies when it was small.
背景/目的:本研究旨在阐明乙型肝炎病毒和丙型肝炎病毒相关肝细胞癌的临床病理差异。
对168例接受肝细胞癌切除术的患者进行病毒性肝炎检测。10例(6%)同时存在乙型肝炎表面抗原和丙型肝炎病毒抗体。33例(20%)两种标志物均未检测到。16例(9%)仅存在乙型肝炎表面抗原(B组),109例(65%)仅存在丙型肝炎病毒抗体(C组)。我们对B组和C组进行了临床病理比较。
B组的平均肿瘤直径大于C组(6.3 cm对3.4 cm),而B组患者比C组患者年轻(48岁对62岁,p<0.0001)。C组经常出现肝功能差、组织学肝硬化和慢性活动性肝炎。B组术后1年和2年无瘤生存率分别为67%和33%,C组分别为73%和49%。B组术后1年、2年和3年生存率分别为78%、68%和0%,C组分别为92%、83%和76%(p=0.0189)。
发现合并乙型肝炎病毒感染的肝细胞癌在肝功能障碍较轻的年轻患者中表现为较大的肿瘤。合并丙型肝炎病毒感染的肝细胞癌在随访研究中通常在肿瘤较小时被检测到。