Hepatocellular carcinoma - An epidemiologic view
Hepatocellular carcinoma - An epidemiologic view
复制标题
DOI：
10.1097/00004836-200211002-00002
复制
发表时间：
2002-11-01
影响因子：
2.9
通讯作者：
El-Serag, HB
中科院分区：
文献类型：
--
作者：
El-Serag, HB
肝细胞癌（HCC）是世界上第五大常见恶性肿瘤，据估计每年造成约50万人死亡。由于其高死亡率，发病率和死亡率几乎相等。HCC的主要危险因素是慢性B型肝炎病毒感染、慢性丙型肝炎病毒（HCV）感染和酒精性肝硬化。HCC的流行病学特征为显著的人口统计学（年龄、性别;人种/种族）和地理变异。B型肝炎病毒感染，有或没有黄曲霉毒素暴露，是发展中国家大多数病例的原因;对这些风险因素的更好控制导致了最近台湾和中国等一些地方HCC的下降。然而，最近，在欧洲和北美的几个发达国家报告了HCC发病率上升的趋势。这些新的趋势与“新的”风险因素有关，如HCV和糖尿病。在美国，过去30年来，肝细胞癌的发病率大约增加了一倍。白色人比非裔美国人少两到三倍，而非裔美国人又比亚洲人、太平洋岛民或美洲原住民少两到三倍。男性比女性多两到三倍。随着HCC发病率的上升，发病率从典型的老年患者转移到40至60岁之间的相对年轻患者。HCV相关HCC的增加占美国HCC增加的至少一半。肝细胞癌的总体生存率仍然很低（接近5%）;很少有患者有资格接受潜在的治愈性治疗。HCC的未来发病趋势将在很大程度上取决于HCV感染者的临床病程。
Hepatocellular carcinoma (HCC) is the fifth most common malignancy in the world and is estimated to cause approximately half a million deaths annually. Because of its high fatality rates, the incidence and mortality rates are almost equal. The major risk factors for HCC are chronic hepatitis B virus infection, chronic hepatitis C virus (HCV) infection, and alcoholic cirrhosis. The epidemiology of HCC is characterized by marked demographic (age, gender; race/ethnicity) and geographic variations. Hepatitis B virus infection, with and without aflatoxin exposure, is responsible for most cases in developing countries; better control of these risk factors has resulted in a recent decline in HCC in some places like Taiwan and China. Recently, however, a trend of rising rates of HCC has been reported from several developed countries in Europe and North America. These new trends are associated with ''new'' risk factors such as HCV and, possibly, diabetes. In the United States, the incidence of HCC has approximately doubled over the past 3 decades. White individuals are two to three times less often affected than African Americans, who in turn are two to three times less often affected than Asians, Pacific Islanders, or Native Americans. Men are two to three times more often affected than women. Concomitant with the rising rates of HCC, there has been a shift of incidence from typically elderly patients to relatively younger patients between ages of 40 to 60 years. An increase in HCV-related HCC accounts for at least half of the witnessed increase in HCC in the United States. Hepatocellular carcinoma continues to carry an overall dismal survival rate (close to 5%); very few patients qualify for and receive potentially curative therapy. The future incidence trends of HCC will be determined to a large extent by the clinical course of HCV-infected people.