Hepatic steatosis is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C virus infection
Hepatic steatosis is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C virus infection
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DOI：
10.1002/cncr.11427
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发表时间：
2003-06-15
期刊：
影响因子：
6.2
通讯作者：
Eguchi, K
中科院分区：
文献类型：
--
作者：
Ohata, K;Hamasaki, K;Eguchi, K
背景。肝脂肪变性是慢性丙型肝炎的组织病理学特征之一。最近有报道称，丙型肝炎病毒（HCV）核心蛋白在转基因小鼠中表达可诱导与脂肪变性相关的肝细胞癌（HCC）。本研究的目的是确定慢性HCV感染患者肝脂肪变性与肝癌发生之间的关系。作者研究了1980年1月至1999年12月在日本长崎长崎大学医院诊断的161例慢性HCV感染患者。采用单因素和多因素分析，探讨年龄、性别、体重指数（BMI）、习惯性饮酒、糖尿病、血清丙氨酸转氨酶（ALT）水平、HCV血清型、HCV核心蛋白水平、干扰素（IFN）治疗、肝纤维化炎症和肝脂肪变性在HCC发生中的意义。5年、10年和15年的HCC累积发病率分别为24%、51%和63%。多因素分析发现，肝脂肪变性、衰老、肝硬化和未使用干扰素治疗是HCC的独立和显著危险因素（P = 0.0135、P = 0.0390、P = 0.0068和P = 0.0142）。此外，肝脂肪变性与BMI、血清ALT水平和甘油三酯水平相关。目前的研究结果表明，肝脂肪变性是慢性HCV感染患者发生HCC的危险因素。慢性丙型肝炎和肝脂肪变性患者应仔细监测肝细胞癌。(C) 2003年美国癌症协会。
BACKGROUND. Hepatic steatosis is one of the histopathologic features of chronic hepatitis C. It was reported recently that the expression of hepatitis C virus (HCV) core protein in transgenic mice induced hepatocellular carcinoma (HCC) in association with steatosis. The objective of this study was to determine the relation between hepatic steatosis and hepatocarcinogenesis in patients with chronic HCV infection.METHODS. The authors studied 161 patients with chronic HCV infection who were diagnosed at Nagasaki University Hospital, Nagasaki, Japan, between January 1980 and December 1999. Age, gender, body mass index (BMI), habitual drinking, diabetes mellitus, serum alanine aminotransferase (ALT) level, HCV serotype, serum level of HCV core protein, interferon (IFN) treatment, hepatic fibrosis inflammation, and hepatic steatosis were studied with regard to their significance in the development of HCC using univariate and multivariate analyses.RESULTS. The cumulative incidence rates of HCC were 24%, 51%, and 63% at 5 years, 10 years, and 15 years, respectively. Multivariate analysis identified hepatic steatosis, together with aging, cirrhosis, and no IFN treatment, as independent and significant risk factors for HCC (P 0.0135, P = 0.0390, P = 0.0068, and P 0.0142, respectively). In addition, hepatic steatosis was correlated with BMI, serum ALT levels, and triglyceride levels.CONCLUSIONS. The findings of the current study indicate that hepatic steatosis is a risk factor for HCC in patients with chronic HCV infection. Patients with chronic HCV and hepatic steatosis should be monitored carefully for HCC. (C) 2003 American Cancer Society.