Increasing incidence of non-HBV- and non-HCV-related hepatocellular carcinoma: single-institution 20-year study.
Increasing incidence of non-HBV- and non-HCV-related hepatocellular carcinoma: single-institution 20-year study.
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DOI：
10.1186/s12876-021-01884-5
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发表时间：
2021-07-31
影响因子：
2.4
通讯作者：
Aikata H
中科院分区：
文献类型：
--
作者：
Nagaoki Y;Hyogo H;Ando Y;Kosaka Y;Uchikawa S;Nishida Y;Teraoka Y;Morio K;Fujino H;Ono A;Nakahara T;Murakami E;Yamauchi M;Okamoto W;Kawaoka T;Tsuge M;Hiramatsu A;Miki D;Imamura M;Takahashi S;Chayama K;Aikata H
我们之前报道了1995年至2009年间诊断为肝细胞癌（HCC）的患者的病因趋势。我们更新研究的目的是评估1992年至2018年期间发生在患者中的HCC的发病率、非B型肝炎和非丙型肝炎病毒（NBNC）病因以及临床特征。该研究在1992年至2018年期间招募了2171名连续的HCC患者。他们的医疗记录被审查。患者分为两组，1992年至2009年早期诊断的患者和2010年至2018年晚期诊断的患者。NBNC-HCC发生514例（23.6%）。患有NBNC-HCC的HCC患者比例从2009年的26.5%增加到2018年的46.3%。NBNC-HCC患者年龄较大（中位年龄为67至73岁）。2型糖尿病（48.5 - 60.3%：P = 0.008）、高血压（48.5 - 57.4%：P = 0.047）和高脂血症（39.2 - 53.8%：P = 0.001）近年来显著增加。中位FIB-4指数降低（4.37 - 3.61：P = 0.026），中位血小板计数升高（15.1 - 17.9 × 104/μ L：P = 0.013）。在514例NBNC-HCC患者中，194例因非酒精性脂肪性肝炎（NASH）（15%）、酒精性肝病（ALD）（29%）和隐源性肝炎（56%）接受了肝切除术。在NASH、ALD和隐源性肝炎患者中，分别有72%、39%和16%的患者检测到肝硬化。NASH组肝硬化发生率明显高于其他各组（P <0.001）。总体而言，NBNC-HCC患者70%的非恶性肝组织未涉及肝硬化。另一方面，隐源性HCC患者的中位FIB-4指数为2.56，显著低于其他患者组的值。FIB-4指标可作为肝癌筛查的有效指标之一。NBNC-HCC的患病率甚至在地区大学医院也迅速增加。代谢综合征可能是HCC的重要危险因素。肝细胞癌也见于非肝硬化患者。FIB-4指标可能是NBNC患者中HCC的一种有用的筛查方法。
We previously reported on the trends in the etiologies of hepatocellular carcinoma (HCC) diagnosed in patients between 1995 and 2009. The aims of our updated study were to evaluate the incidence, nonhepatitis B and nonhepatitis C viral (NBNC) etiologies, and clinical characteristics of HCCs occurring in patients between 1992 and 2018. The study enrolled 2171 consecutive patients with HCC between 1992 and 2018. Their medical records were reviewed. The patients were divided into two groups, patients with early diagnoses from 1992 to 2009 and those with late diagnoses from 2010 to 2018. NBNC-HCC occurred in 514 patients (23.6%). The percentage of patients with HCC who had NBNC-HCC increased from 26.5% in 2009 to 46.3% in 2018. Patients with NBNC-HCC were older (median ages from 67 to 73 years). Type 2 diabetes mellitus (48.5–60.3%: P = 0.008), hypertension (48.5–57.4%: P = 0.047), and hyperlipidemia (39.2–53.8%: P = 0.001) increased significantly in recent years. The median FIB-4 index decreased (4.37–3.61: P = 0.026) and the median platelet count increased (15.1–17.9 × 104/μL: P = 0.013). Among the 514 patients with NBNC-HCC, 194 underwent hepatic resection for nonalcoholic steatohepatitis (NASH) (15%), alcoholic liver disease (ALD) (29%), and cryptogenic hepatitis (56%). Cirrhosis was detected in 72%, 39%, and 16% of patients with NASH, ALD, and cryptogenic hepatitis, respectively. The prevalence of cirrhosis in patients with NASH was significantly higher than the prevalence of cirrhosis in the other groups (P < 0.001). Overall, 70% of the non-malignant liver tissue of patients with NBNC-HCC was not involved with cirrhosis. On the other hand, the median FIB-4 index in patients with cryptogenic HCC was 2.56, which was a significantly lower value than those values in the other groups of patients. The FIB-4 index considered as one of useful screening of HCC. The prevalence of NBNC-HCC has increased rapidly even in a regional university hospital. Metabolic syndrome may be an important risk factor for HCC. HCC was also found in patients with non-cirrhotic livers. The FIB-4 index may be a useful screening method for HCC in patients with NBNC.
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DOI：
10.1016/j.cgh.2017.11.045
发表时间：
2018-08
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Cholankeril G;Ahmed A
通讯作者：
Ahmed A
影响因子：
254.7
作者：
Giovannucci, Edward;Harlan, David M.;Yee, Douglas
通讯作者：
Yee, Douglas
影响因子：
25.7
作者：
Bertuccio, Paola;Turati, Federica;Negri, Eva
通讯作者：
Negri, Eva
影响因子：
2.3
作者：
Besheer, Tarek;El-Bendary, Mahmoud;Abd Elwahab, Mohamed
通讯作者：
Abd Elwahab, Mohamed
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F