Visceral fat accumulation is an independent risk factor for hepatocellular carcinoma recurrence after curative treatment in patients with suspected NASH
Visceral fat accumulation is an independent risk factor for hepatocellular carcinoma recurrence after curative treatment in patients with suspected NASH
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DOI：
10.1136/gut.2008.164053
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发表时间：
2009-06-01
期刊：
影响因子：
24.5
通讯作者：
Omata, M.
中科院分区：
文献类型：
--
作者：
Ohki, T.;Tateishi, R.;Omata, M.
背景和目的：据报道，内脏脂肪积聚增加了慢性肝病患者发生肝细胞癌（HCC）的风险。然而，对于疑似非酒精性脂肪性肝炎（NASH）患者，内脏脂肪堆积是否会增加治愈性治疗后HCC复发的风险尚未完全阐明。方法：62例初治肝癌伴NASH患者入选。所有患者均在1999年至2006年期间接受经皮射频消融治疗。内脏脂肪面积（VFA）确定在每个病人的CT图像，采取在HCC诊断的时间。根据VFA将患者分为两组：高VFA组（男性>130 cm（2），女性>90 cm（2），n = 27）和其他组（n = 35）。分析VFA对肝癌复发的影响，并与患者的背景、肿瘤相关因素、肝功能相关因素等进行比较。高VFA组第1、2和3年时分别为15.9、56.5和75.1%，对照组分别为9.7、31.1和43.1%（p = 0.018）。多因素分析显示内脏脂肪堆积（危险比1.08/10 cm 2，p = 0.046）和年龄较大（危险比1.06/1年，p = 0.04）是HCC复发的独立危险因素。结论：内脏脂肪堆积是疑似NASH患者根治性治疗后HCC复发的独立危险因素。
Background and Aim: Visceral fat accumulation reportedly increases the risk of hepatocellular carcinoma (HCC) development in patients with chronic liver disease. However, it has not beeen fully elucidated whether visceral fat accumulation increases the risk of HCC recurrence after curative treatment in patients with suspected non-alcoholic steatohepatitis (NASH). Therefore this was investigated in the current study.Methods: 62 patients with naive HCC with suspected NASH were enrolled. All were curatively treated with percutaneous radiofrequency ablation between 1999 and 2006. The visceral fat area (VFA) was determined in each patient from CT images, taken at the time of HCC diagnosis. Patients were divided into two groups based on VFA: the high VFA group (>130 cm(2) in males, >90 cm(2) in females, n = 27) and the others (n = 35). The effects of VFA on HCC recurrence were analysed together with other factors including patients' background, tumour-related factors and liver function-related factors.Results: The cumulative recurrence rates differed significantly between the two groups; 15.9, 56.5 and 75.1% at 1, 2 and 3 years, respectively, in the high VFA group, and 9.7, 31.1 and 43.1%, respectively, in the controls (p = 0.018). Multivariate analysis indicated visceral fat accumulation (risk ratio 1.08, per 10 cm(2), p = 0.046) and older age (risk ratio 1.06 per 1 year, p = 0.04) as independent risk factors of HCC recurrence.Conclusions: Visceral fat accumulation is an independent risk factor of HCC recurrence after curative treatment in patients with suspected NASH.