Shiraishi M, Hiroyasu S, Nagahama M, Tomita S, Miyahira T, Kusano T, Furukawa M, Muto Y
First Department of Surgery, University of Ryukyus, School of Medicine, Uehara 207, Nishihara-cho, Okinawa 903-01, Japan.
World J Surg. 1999 Mar;23(3):301-5. doi: 10.1007/pl00013187.
Fifty-one cases of resected hepatocellular carcinoma (HCC) were retrospectively analyzed to evaluate the clinicopathologic features of HCC in patients with negative virus markers. The data were compared between three groups: hepatitis B surface antigen positive (HB, n = 11), hepatitis C virus antibody positive (HC, n = 21), and non-BC (both HbsAg and HCVAb negative, n = 12). Seven patients were excluded from the study because of operative death (n = 3), a history of alcohol abuse (n = 3), or the presence of dual positive HB and HC virus markers (n = 1). The data were analyzed by either an analysis of variance (ANOVA) or a contingency table. The age of the non-BC patients was higher (63.0 +/- 4.1, +/- SE) than that of HB patients (54.0 +/- 3.2, p < 0.05) but was identical to that of the HC group (62.0 +/- 1.8). Among the preoperative laboratory data, the serum glutamic oxaloacetate and glutamate pyruvate transaminoses (GOT, GPT) levels were statistically lower in the non-BC patients (32.8 +/- 4.8 and 28.0 +/- 4.4 IU/L, respectively) than in the HB and HC patients. The pathologic features of the resected specimens in the non-BC patients showed more invasive growth than in specimens from the HB or HC patients. The clinical stages (defined based on the criteria of the Japanese Association of Hepatocellular Carcinoma) were also more advanced in the non-BC patients than in the other groups. Postoperative survival time showed no significant difference among the groups. In conclusion, the non-BC patients had comparatively greater invasive growth and more advanced clinical stages than the HB and HC patients, despite the absence of liver cirrhosis, and so demonstrated the same poor survival data as observed in the HB and HC patients.
回顾性分析51例手术切除的肝细胞癌(HCC)病例,以评估病毒标志物阴性患者中HCC的临床病理特征。将数据在三组之间进行比较:乙型肝炎表面抗原阳性(HB,n = 11)、丙型肝炎病毒抗体阳性(HC,n = 21)和非乙非丙(乙肝表面抗原和丙肝抗体均阴性,n = 12)。7例患者因手术死亡(n = 3)、有酗酒史(n = 3)或同时存在乙肝和丙肝病毒标志物阳性(n = 1)而被排除在研究之外。通过方差分析(ANOVA)或列联表对数据进行分析。非乙非丙患者的年龄(63.0±4.1,±标准误)高于HB患者(54.0±3.2,p < 0.05),但与HC组(62.0±1.8)相同。在术前实验室数据中,非乙非丙患者的血清谷草转氨酶和谷丙转氨酶(GOT、GPT)水平(分别为32.8±4.8和28.0±4.4 IU/L)在统计学上低于HB和HC患者。非乙非丙患者切除标本的病理特征显示出比HB或HC患者的标本更具侵袭性生长。非乙非丙患者的临床分期(根据日本肝细胞癌协会的标准定义)也比其他组更晚。术后生存时间在各组之间无显著差异。总之,非乙非丙患者尽管没有肝硬化,但与HB和HC患者相比,具有相对更大的侵袭性生长和更晚的临床分期,因此显示出与HB和HC患者相同的不良生存数据。