Hepatocellular carcinoma in Japanese patients with nonalcoholic fatty liver disease, alcoholic liver disease, and chronic liver disease of unknown etiology: report of the nationwide survey
Hepatocellular carcinoma in Japanese patients with nonalcoholic fatty liver disease, alcoholic liver disease, and chronic liver disease of unknown etiology: report of the nationwide survey
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DOI：
10.1007/s00535-011-0431-9
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发表时间：
2011-10-01
影响因子：
6.3
通讯作者：
Higuchi, Susumu
中科院分区：
文献类型：
--
作者：
Tokushige, Katsutoshi;Hashimoto, Etsuko;Higuchi, Susumu
目的为了明确日本非病毒性肝病患者中肝细胞癌的病因，我们进行了一项全国性的调查。重点关注肥胖、生活方式相关疾病和饮酒的影响。方法2009年对14530名肝癌患者进行了全国范围的调查。对合并非酒精性脂肪性肝病(NAFLD-HCC；n=292)、酒精性肝病(ALC-HCC；n=991)和病因不明的慢性肝病(n=614)的肝细胞癌患者的临床特征进行了研究。结果ALC-肝细胞癌占全部肝细胞癌的7.2%，其次为不明原因肝细胞癌(5.1%)和非酒精性肝细胞癌(2.0%)。三组人群的特征有明显不同(NAFLD-HCC中位年龄72岁，ALC-HCC中位年龄68岁，不明原因肝细胞癌中位年龄73岁，p<；0.01；女性分别为38，4，37%，p<；0.01)。肥胖症和生活方式相关疾病在非酒精性脂肪肝-肝细胞癌中的发生率显著高于ALC-肝细胞癌和不明原因的肝细胞癌。不饮酒的不明原因肝细胞癌患者以女性为主(58%)，且年龄较大，没有肥胖和生活方式相关疾病的高患病率。结论ALC-肝细胞癌、非酒精性脂肪肝-肝细胞癌和不明原因肝细胞癌在性别、体重指数、生活方式相关疾病、肝功能等方面的变化趋势明显不同。适量饮酒可能在肝癌的发生中起到比目前认为的更重要的作用。
Purpose To clarify the etiology of hepatocellular carcinoma (HCC) in Japanese patients with non-viral liver disease, we performed a nationwide survey. The influence of obesity, lifestyle-related diseases, and alcohol consumption was focused on.Methods A nationwide survey of 14,530 HCC patients was conducted in 2009. Clinical features were studied for HCC patients with nonalcoholic fatty liver disease (NAFLD-HCC; n = 292), alcoholic liver disease (ALC-HCC; n = 991), and chronic liver disease of unknown etiology (unknown HCC; n = 614). The unknown HCC was divided into two subgroups, a no alcohol intake group and a modest alcohol intake group.Results ALC-HCC accounted for 7.2% of all HCC, followed by unknown HCC (5.1%) and NAFLD-HCC (2.0%). The characteristics of these three groups were clearly different (median age was 72 years for NAFLD-HCC, 68 years for ALC-HCC, and 73 years for unknown HCC, p < 0.01; female gender was 38, 4, and 37%, respectively, p < 0.01). Obesity and lifestyle-related diseases were significantly more frequent in NAFLD-HCC than in ALC-HCC and unknown HCC. The no alcohol intake subgroup of unknown HCC showed female predominance (58%) and was older, without a high prevalence of obesity and lifestyle-related diseases. In contrast, the modest alcohol intake subgroup showed the same trends regarding gender, body mass index, prevalence of lifestyle-related diseases, and liver function as the ALC-HCC group.Conclusions The clinical features of ALC-HCC, NAFLD-HCC, and unknown HCC were clearly different. Modest intake of alcohol might have a more significant role in hepatic carcinogenesis than is presently thought.