Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis
Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis
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DOI：
10.1016/j.ajg.2019.01.006
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发表时间：
2019-03-01
影响因子：
1.4
通讯作者：
Khalaf, Hatem
中科院分区：
文献类型：
--
作者：
Elmoghazy, Walid;Ahmed, Khalid;Khalaf, Hatem
背景与研究目的：肝细胞癌合并肝外转移已有研究，但来自中东的资料尚不多见。在这项研究中，我们评估了卡塔尔肝癌的流行病学，并确定了转移行为的预测因素。患者和方法：所有在2011至2015年间新诊断的肝细胞癌患者在肝硬化的基础上被纳入研究。结果：共有180名患者符合我们的纳入标准。平均年龄58.8±10.5岁，平均随访1.0±1.1年。其中男性患者150例，丙型肝炎病毒感染是最常见的肝硬变原因108例(60%)，肝功能Child-Pugh C级22例(12.2%)，总存活率51.1%，其中47例(26%)在确诊时至少有一次肝外转移。对确诊时有转移者和未转移者进行多因素分析，发现肿瘤直径>5 cm(OR=6.1095%CI=1.85~20.12)(p=0.003)和肝双叶受累(OR=5.49，95%CI=1.10~27.30)(p=0.037)是影响肝癌转移行为的独立危险因素。肝外转移不再少见，大于5厘米的肿瘤和胆叶受累是肝外转移的决定因素。(C)2019年泛阿拉伯胃肠病学会。爱思唯尔出版，版权所有。
Background and study aims: Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour.Patients and methods: All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study.Results: A total of 180 patients met our inclusion criteria. The mean age was 58.8 +/- 10.5 years with a mean follow-up of 1.0 +/- 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases.We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85-20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10-27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC.Conclusion: The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis. (C) 2019 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.