无肝硬化患者肝细胞癌的特征，病因和趋势：美国多中心研

StephenW

Aliment Pharmacol Ther. 2019 Sep 1. doi: 10.1111/apt.15464. [Epub ahead of print]
Characteristics, aetiologies and trends of hepatocellular carcinoma in patients without cirrhosis: a United States multicentre study.
Gawrieh S1, Dakhoul L1, Miller E2, Scanga A3, deLemos A4, Kettler C1, Burney H1, Liu H1, Abu-Sbeih H2, Chalasani N1, Wattacheril J5.
Author information

1
    Indiana University School of Medicine, Indianapolis, Indiana.
2
    MD Anderson Cancer Center, Houston, Texas.
3
    Vanderbilt University School of Medicine, Nashville, Tennessee.
4
    Atrium Health, Charlotte, North Carolina.
5
    Columbia University Vagelos College of Physicians and Surgeons, New York, New York.

Abstract
BACKGROUND:

Limited data exist on the burden and features of non-cirrhotic hepatocellular carcinoma (HCC) in the United States.
AIM:

To evaluate characteristics, aetiologies, trends and outcomes of non-cirrhotic HCC from 2000 to 2014 at five large US centres METHODS: Patient, tumour and liver disease aetiology data were collected. The presence of underlying cirrhosis was assessed based on published criteria.
RESULTS:

Of 5144 eligible patients with HCC, 11.7% had no underlying cirrhosis. Non-cirrhotic patients were older (64.1 vs 61.2 years), more frequently females (33.9% vs 20.8%) and less frequently black (8.3% vs 12.4%) (P < .001 for all). Among non-cirrhotic patients, non-alcoholic fatty liver disease (NAFLD) was the most common liver disease (26.3%), followed by hepatitis C virus (HCV) (12.1%) and hepatitis B virus (HBV) (10%) infections. As of 2014, there was increased percentage of cirrhotic HCC and a decline in non-cirrhotic HCC mainly due to significant annual increases in cirrhotic HCC due to HCV (0.96% [P < .0001]) and NAFLD (0.66% [P = .003]). Patients with non-cirrhotic HCC had larger tumours (8.9 vs 5.3 cm), were less frequently within Milan criteria (15% vs 39%), more frequently underwent resection (43.6% vs 8%) (P < .001 for all) and had better overall survival than cirrhotic HCC patients (median 1.8 vs 1.3 years, P = .004).
CONCLUSIONS:

Nearly 12% of HCCs occurred in patients without underlying cirrhosis. NAFLD was the most common liver disease in these patients. During the study, the frequency of non-cirrhotic HCC decreased, whereas that of cirrhotic HCC increased. Although non-cirrhotic patients presented with more advanced HCC, their survival was better.

© 2019 John Wiley & Sons Ltd.

PMID:
    31475372
DOI:
    10.1111/apt.15464

StephenW

Aliment Pharmacol Ther。 2019年9月1日：doi：10.1111 / apt.15464。 [印刷前的电子版]
无肝硬化患者肝细胞癌的特征，病因和趋势：美国多中心研究。
Gawrieh S1，Dakhoul L1，Miller E2，Scanga A3，deLemos A4，Kettler C1，Burney H1，Liu H1，Abu-Sbeih H2，Chalasani N1，Wattacheril J5。
作者信息

1
印第安纳州印第安纳波利斯印第安纳大学医学院。
2
德克萨斯州休斯顿MD安德森癌症中心。
3
田纳西州纳什维尔范德比尔特大学医学院。
4
Atrium Health，北卡罗来纳州夏洛特市。
五
哥伦比亚大学Vagelos医师和外科医生学院，纽约，纽约。

抽象
背景：

关于美国非肝硬化肝细胞癌（HCC）的负担和特征的数据有限。
目标：

评估2000年至2014年在美国五大中心的非肝硬化HCC的特征，病因，趋势和结果。方法：收集患者，肿瘤和肝脏疾病的病因数据。根据公布的标准评估潜在肝硬化的存在。
结果：

在符合条件的514例HCC患者中，11.7％没有潜在的肝硬化。非肝硬化患者年龄较大（64.1对61.2岁），女性更常见（33.9％对20.8％），黑人较少（8.3％对12.4％）（所有人均P <.001）。在非肝硬化患者中，非酒精性脂肪性肝病（NAFLD）是最常见的肝病（26.3％），其次是丙型肝炎病毒（HCV）（12.1％）和乙型肝炎病毒（HBV）（10％）感染。截至2014年，肝硬化HCC百分比增加，非肝硬化HCC下降，主要原因是HCV肝硬化（0.96％[P <.0001]）和NAFLD（0.66％[P =。 003]）。非肝硬化HCC患者肿瘤较大（8.9 vs 5.3 cm），米兰标准较少（15％vs 39％），更常见的是切除（43.6％vs 8％）（P <.001）总体生存率高于肝硬化HCC患者（中位数为1.8对1。3年，P = .004）。
结论：

在研究期间，非肝硬化HCC的频率降低，而肝硬化HCC的频率增加。尽管非肝硬化患者患有更高级的HCC，但他们的生存率更高。

©2019 John Wiley＆Sons Ltd.

结论：
31475372
DOI：
10.1111 / apt.15464

StephenW

https://onlinelibrary.wiley.com/doi/full/10.1111/apt.15464

neilhbver

好消息，危险因素可控