A comparison of survival and pathologic features of non-alcoholic steatohepatitis and hepatitis C virus patients with hepatocellular carcinoma
A comparison of survival and pathologic features of non-alcoholic steatohepatitis and hepatitis C virus patients with hepatocellular carcinoma
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DOI：
10.3748/wjg.v18.i31.4145
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发表时间：
2012-08-21
影响因子：
4.3
通讯作者：
Quan, Douglas
中科院分区：
文献类型：
--
作者：
Hernandez-Alejandro, Roberto;Croome, Kris P.;Quan, Douglas
目的：比较非酒精性脂肪性肝炎(NASH)合并肝细胞癌(HCC)和丙型肝炎病毒(HCV)合并肝细胞癌(肝细胞癌)患者接受肝移植的临床转归和病理特点。所有移植的肝组织学和移植前的肝活检都由两位专业的肝组织病理学家进行检查。比较丙型肝炎和非酒精性肝炎肝移植患者的人口学特征、无病生存率、外植体肝脏特征和肝细胞癌的特征(肿瘤数量、累积肿瘤大小、血管侵袭和分化)。结果：共102例非酒精性肝炎患者和283例丙型肝炎患者接受了肝移植。NASH移植受者肝细胞癌发生率为16.7%(17/102)。肝细胞癌的发生率为22.6%(/283)。在统计学上，NASH-肝癌患者比丙型肝炎患者年龄更大(P<；0.001)。丙型肝炎肝细胞癌患者有血管侵犯(23.4%比6.4%，P=0.002)和低分化肝细胞癌(4.7%比0%，P<；0.001)明显高于非酒精性肝细胞癌组。与接受肝移植的非酒精性肝癌患者相比，丙型肝炎患者5年的无复发生存率较低(P=0.11)。结论：与丙型肝炎患者相比，非酒精性肝癌患者的肿瘤特征较差，这可能是其提高无复发生存率的部分原因。(C)2012年白石登。版权所有。
AIM: To compare the clinical outcome and pathologic features of non-alcoholic steatohepatitis (NASH) patients with hepatocellular carcinoma (HCC) and hepatitic C virus (HCV) patients with HCC (another group in which HCC is commonly seen) undergoing liver transplantation.METHODS: Patients transplanted for HCV and NASH at our institution from January 2000 to April 2011 were analyzed. All explanted liver histology and pre-transplant liver biopsies were examined by two specialist liver histopathologists. Patient demographics, disease free survival, explant liver characteristics and HCC features (tumour number, cumulative tumour size, vascular invasion and differentiation) were compared between HCV and NASH liver transplant recipients.RESULTS: A total of 102 patients with NASH and 283 patients with HCV were transplanted. The incidence of HCC in NASH transplant recipients was 16.7% (17/102). The incidence of HCC in HCV transplant recipients was 22.6% (64/283). Patients with NASH-HCC were statistically older than HCV-HCC patients (P < 0.001). A significantly higher proportion of HCV-HCC patients had vascular invasion (23.4% vs 6.4%, P = 0.002) and poorly differentiated HCC (4.7% vs 0%, P < 0.001) compared to the NASH-HCC group. A trend of poorer recurrence free survival at 5 years was seen in HCV-HCC patients compared to NASH-HCC who underwent a Liver transplantation (P = 0.11).CONCLUSION: Patients transplanted for NASH-HCC appear to have less aggressive tumour features compared to those with HCV-HCC, which likely in part accounts for their improved recurrence free survival. (C) 2012 Baishideng. All rights reserved.