Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients.
Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients.
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作者：
Akkiz H;Carr BI;Yalçın K K;Guerra V;Kuran S;Altıntaş E;Üsküdar O;Karaoğullarından Ü;Özakyol A;Tokmak S;Yücesoy M;Bahçeci Hİ;Ülkü A;Akçam T;Yalçın Polat K;Ekinci N;Şimşek H;Örmeci N;Sonsuz A;Demir M;Kılıç M;Uygun A;Ballı T;Demir A;Arslan B;Doran F
对来自土耳其几个合作机构的大量肝癌患者进行了肿瘤参数最大直径(MTD)、门静脉血栓形成(PVT)和甲胎蛋白(AFP)水平的检查。MTD与血小板水平呈正相关。血小板水平正常的≥5 cm大肿瘤患者的肿瘤体积明显大于≥5 cm肿瘤患者(P<0.0 5)，PVT百分比较高，血总胆红素和肝硬变明显低于类似的伴有血小板减少的患者。比较有无PVT的患者，发现PVT患者的肿瘤明显更大，多灶性更强，血液AFP和C-反应蛋白水平以及有趣的是，较低的高密度脂蛋白水平。58%的患者甲胎蛋白水平≤为100IU/ml(42.1%的患者≤为20IU/ml)。这些患者的肿瘤明显较小，肿瘤多灶性和PVT百分比较低，总胆红素较低，肝硬变较少。在土耳其，肝细胞癌的表现有相当大的地域异质性，有高的和低的乙肝病毒、HDV、肝硬变和肿瘤侵袭性参数的地区。因此，土耳其患者有不同的表现模式，但MTD与血小板和胆红素水平之间的生物学关系与其他民族患者群体中已报告的关系相似。
A large cohort of HCC patients from several collaborating Turkish institutions was examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis(PVT) and alpha-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5cm tumors who had normal platelet levels had significantly larger tumors, higher percent PVT and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5cm tumor patients having thrombocytopenia. Comparison of patients with and without PVT, showed significantly larger tumors, greater multifocality, blood AFP and C-reactive protein levels and interestingly, lower HDL levels in the patients with PVT. Fifty-eight % of the total cohort had AFP levels ≤100 IU/ml (and 42.1% had values ≤20 IU/ml). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower HBV, HDV, cirrhosis and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups.
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