Differences in prognostic factors according to viral status in patients with hepatocellular carcinoma
Differences in prognostic factors according to viral status in patients with hepatocellular carcinoma
复制标题
DOI：
10.3892/or_00000766
复制
发表时间：
2010-05-01
期刊：
影响因子：
4.2
通讯作者：
Nakao, Kazuhiko
中科院分区：
文献类型：
--
作者：
Akahoshi, Hiroshi;Taura, Naota;Nakao, Kazuhiko
在日本，乙肝表面抗原和丙型肝炎病毒抗体阴性的肝细胞癌(HCC-non BC)病例的数量和比例一直在稳步上升。本研究的目的是检测筛查方法检出的肝细胞癌-非BC细胞的频率，并与丙型肝炎和/或B病毒相关的肝细胞癌(肝细胞癌病毒)的临床特征进行比较。我们招募了624名在1982-2007年间在长崎大学医院消化科和肝科确诊的肝细胞癌患者。分为2组：1)肝细胞癌病毒组550例：HBs Ag阳性和/或丙型肝炎抗体阳性；2)74例肝细胞癌非结直肠癌组：HBs Ag和丙型肝炎抗体均阴性。分析比较两组患者首次发现肝细胞癌前的随访方式和生存率。多因素分析显示，随访、饮酒、白蛋白水平、总胆红素水平、甲胎蛋白(AFP)水平、肿瘤转移(TNM)分期是影响预后的独立危险因素。在397例TNM分期为I或II期的肝细胞癌患者中，多因素分析确定了肝病的病因、性别。Child-Pugh评分、血清白蛋白水平和TNM分期是影响预后的独立危险因素。我们报道，由于缺乏早期发现肝细胞癌的监测系统，晚期肝细胞癌患者预后不良是由于其晚期发现较晚所致。然而，在早期患者中，肝细胞癌-非BC组患者的预后明显好于肝细胞癌病毒组。
The number and ratio of both HBsAg- and HCV Ab-negative hepatocellular carcinoma (HCC-nonBC) cases have been steadily increasing in Japan. The aim of this study was to examine the frequency of detection of HCC-nonBC by screening methods and to elucidate the clinical characteristics of HCC-nonBC compared with those of hepatitis C and/or B virus-associated HCC (HCC-virus). We recruited 624 patients with HCC who were diagnosed between 1982 and 2007 at the Department of Gastroenterology and Hepatology, Nagasaki University Hospital. They were categorized into 2 groups as follows: i) 550 were included in the HCC-virus group: positive for HBsAg and/or positive for HCV Ab, and ii) 74 were included in the HCC-nonBC group: negative for both HBsAg and HCV Ab. The follow-up patterns until the initial detection of HCC and the survival rates were analyzed and compared between the 2 groups. Multivariate analysis identified follow-up, alcohol consumption, albumin level, total bilirubin level, alpha-fetoprotein (AFP) level, and tumor-node-metastasis (TNM) stage as independent and significant risk factors for prognosis. Among the 397 patients with HCC in TNM stage I or II, multivariate analysis identified the cause of liver disease, gender. Child-Pugh score, serum albumin level and TNM stage as independent and significant risk factors for prognosis. We reported that the poor prognoses of patients with HCC-nonBC were attributable to its late detection in an advanced condition due to the absence of a surveillance system for the early detection of HCC. However, in early-stage patients, patients with HCC-nonBC showed significantly better prognosis than those in the HCC-virus group.