NAFLD may be a common underlying liver disease in patients with hepatocellular carcinoma in the United States
NAFLD may be a common underlying liver disease in patients with hepatocellular carcinoma in the United States
复制标题
DOI：
10.1053/jhep.2002.36939
复制
发表时间：
2002-12-01
期刊：
影响因子：
13.5
通讯作者：
Lok, AS
中科院分区：
文献类型：
--
作者：
Marrero, JA;Fontana, RJ;Lok, AS
肝细胞癌（HCC）在美国的发病率正在上升，但美国HCC患者的临床特征尚未得到很好的描述。本研究的目的是确定在美国单个中心就诊的HCC患者的肝脏疾病的病因和短期预后。我们连续研究了105例HCC患者；平均年龄59岁，67%为男性，76%为非西班牙裔白人。最常见的病因是丙型肝炎（51%）和隐源性肝硬化（29%）。一半的隐源性肝硬化患者具有与非酒精性脂肪性肝病（NAFLD）相关的组织学或临床特征。53例（50%）患者在监测期间发现HCC（第一组），而其余患者有症状性肿瘤（第二组）。I组患者肿瘤较小（P = 0.01），更有可能适合手术治疗（P = 0.005），与II组患者相比，中位生存期更好（P = 0.001）。隐匿性肝硬化患者接受HCC监测的可能性较小，诊断时肿瘤较大。总之，丙型肝炎和隐源性肝病是HCC患者最常见的病因。NAFLD至少占13%。接受监测的患者肿瘤较小，更有可能进行手术或局部消融治疗。由于NAFLD发病率的增加，需要进一步的研究来确定NAFLD患者发生HCC的风险。
The incidence of hepatocellular carcinoma (HCC) in the United States is increasing, but the clinical characteristics of American patients with HCC have not been well described. The aims of this study were to determine the etiology of liver disease and short-term outcome among HCC patients presenting to a single center in the United States. One hundred five consecutive patients with HCC were studied; mean age was 59 years, 67% were men, and 76% were non-Hispanic white. The most common etiology of liver disease was hepatitis C (51%) and cryptogenic cirrhosis (29%). Half of the patients with cryptogenic cirrhosis had histologic or clinical features associated with nonalcoholic fatty liver disease (NAFLD). Fifty-three (50%) patients had HCC detected during surveillance (group I), whereas the remaining patients had symptomatic tumors (group II). Group I patients had smaller tumors (P = .01), were more likely to be eligible for surgical treatment (P = .005), and had a better median survival compared with patients in group II (P = .001). Patients with cryptogenic cirrhosis were less likely to have undergone HCC surveillance and had larger tumors at diagnosis. In conclusion, hepatitis C and cryptogenic liver disease are the most common etiologies of diseases in our patients with HCC. NAFLD accounted for at least 13% of the cases. Patients who underwent surveillance had smaller tumors and were more likely to be candidates for surgical or local ablative therapies. Because of the increasing incidence of NAFLD, further studies are needed to determine the risk of HCC in patients with NAFLD.