Surgical Outcomes of Hepatic Resection for Hepatitis B Virus Surface Antigen-Negative and Hepatitis C Virus Antibody-Negative Hepatocellular Carcinoma
Surgical Outcomes of Hepatic Resection for Hepatitis B Virus Surface Antigen-Negative and Hepatitis C Virus Antibody-Negative Hepatocellular Carcinoma
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DOI：
10.1245/s10434-014-4261-x
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发表时间：
2015-07-01
影响因子：
3.7
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
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作者：
Yamashita, Yo-ichi;Imai, Daisuke;Maehara, Yoshihiko
B型肝炎病毒表面抗原阴性和C型肝炎病毒抗体阴性肝细胞癌的发病率（NBNC-HCC）正在逐渐增加。对1990年1月至2011年12月期间接受原发性肝癌根治性肝切除术的694例患者进行了回顾性队列研究。在NBNC-HCC组（n = 110）中，糖尿病并发症发生率（38%）明显高于B型肝癌组（n = 110; 17%），并且他们的酗酒率（38%）显著高于B-HCC组（26%）和C-HCC组（n = 474; 22%）。NBNC-HCC组肿瘤直径（4.5 ± A3.6 cm）明显大于C-HCC组（2.9 ± A1.8 cm），但组织学肝硬化发生率（37%）明显低于B-HCC组（67%）和C-HCC组（53%）。三组之间的总体生存率和无病生存率无显著差异。在NBNC-HCC组中，多发性肝内或远处复发（25%）显著高于C-HCC组（17%），肝切除术后2年以上复发率（24%）明显高于B型肝癌组（12%）。HCC与B型和C型HCC相比无显著性差异。在治愈性肝切除术后的NBNC-HCC患者中，有相当多的患者晚期复发，因此不仅需要长期随访，而且需要早期建立预防NBNC-HCC复发的方法。
The incidence of hepatitis B virus surface antigen-negative and hepatitis C virus antibody-negative hepatocellular carcinoma (NBNC-HCC) is gradually increasing.A retrospective cohort study was performed in 694 patients who underwent curative hepatic resection for primary HCC from January 1990 to December 2011.In the NBNC-HCC group (n = 110), the complication rate of diabetic mellitus (38 %) was significantly higher than that of the B-HCC group (n = 110; 17 %), and their rate of alcohol abuse (38 %) was significantly higher than that of both the B-HCC (26 %) and C-HCC groups (n = 474; 22 %). In the NBNC-HCC group, the tumor diameter (4.5 +/- A 3.6 cm) was significantly larger than that of the C-HCC group (2.9 +/- A 1.8 cm), but the rate of histological cirrhosis (37 %) was significantly lower than those of both the B-HCC (67 %) and C-HCC (53 %) groups. There were no significant differences regarding overall and disease-free survival among the three groups. In the NBNC-HCC group, multiple intrahepatic or distant recurrences (25 %) were significantly higher than in the C-HCC group (17 %), and the rate of recurrence more than 2 years after hepatic resection (24 %) was significantly higher than that of the B-HCC group (12 %).The surgical outcomes of patients with NBNC-HCC were not significantly different compared with those of the patients with B-HCC or C-HCC. There was a substantial population with late recurrence among the patients with NBNC-HCC after curative hepatic resection, and thus not only long-term follow-up but also the early establishment of preventive methods for HCC recurrence from NBNC-hepatitis are necessary.