Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong
Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong
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DOI：
10.1111/j.1365-2036.2006.03029.x
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发表时间：
2006-08-15
影响因子：
7.6
通讯作者：
Yuen, M. -F.
中科院分区：
文献类型：
--
作者：
Cheung, T. -K.;Lai, C. -L.;Yuen, M. -F.
背景 肝细胞癌患者的临床特征因筛查而发生变化。目的 探讨香港肝细胞癌患者的临床特征以及不同分期系统的有效性。方法 共研究了 223 名中国肝细胞癌患者。结果 78% 的肝细胞癌患者患有慢性乙型肝炎（43% 诊断为慢性乙型肝炎） 通过筛选）。乙型肝炎阳性、体重减轻、黄疸、脑病、甲胎蛋白水平、门静脉血栓、肝外转移和治疗被证明是影响生存的独立因素。在慢性乙型肝炎患者中，乙型肝炎病毒DNA水平（P = 0.001）和门静脉血栓形成（P = 0.008）是影响生存的独立因素。 76% 的慢性乙型肝炎合并肝细胞癌患者的乙型肝炎 e 抗原呈阴性。筛查患者较早发现肝细胞癌且生存率较高（中位生存期：21 个月与 4 个月，P < 0.0001）。所有分期系统都有良好的生存分层。与美国的数据相比，预后和中位生存期有所不同。结论 慢性乙型肝炎是香港肝细胞癌的最常见原因。无论乙型肝炎 e 抗原状态如何，都应对高危慢性乙型肝炎患者进行随访。诊断时的乙型肝炎病毒 DNA 水平是重要的生存预测指标。筛查可以在早期发现肝细胞癌并延长生存期。分期系统应在不同人群中进行验证。
Background Clinical features of hepatocellular carcinoma patients are changing because of screening.Aim To examine the clinical features of hepatocellular carcinoma patients in Hong Kong and validity of different staging systems.Methods A total of 223 Chinese patients with hepatocellular carcinoma were studied.Results Seventy-eight percent of hepatocellular carcinoma patients had chronic hepatitis B (43% diagnosed by screening). Hepatitis B positivity, weight loss, jaundice, encephalopathy, alpha-fetoprotein level, portal vein thrombosis, extrahepatic metastasis, and treatment were shown to be independent factors affecting survival. Of chronic hepatitis B patients, hepatitis B virus DNA levels (P = 0.001) and portal vein thrombosis (P = 0.008) were independent factors affecting survival. Seventy-six percent of chronic hepatitis B patients with hepatocellular carcinoma were hepatitis B e antigen negative. Screening patients had hepatocellular carcinoma detected at an earlier stage and better survival (median survival: 21 vs. 4 months, P < 0.0001). All staging systems had good stratification of survival. Prognosis and median survival generated were different when compared with the US data.Conclusions Chronic hepatitis B was the most common cause of hepatocellular carcinoma in Hong Kong. High-risk chronic hepatitis B patients should be followed irrespective of the hepatitis B e antigen status. Hepatitis B virus DNA levels at the time of diagnosis are an important survival predictor. Screening detected hepatocellular carcinoma at an earlier stage and prolonged survival. Staging systems should be validated in different populations.