无肝硬化患者的肝细胞癌的特征和病因：当East遇见West

StephenW

Characteristics and etiologies of hepatocellular carcinoma in patients without cirrhosis: When East meets West
Yi-Hao Yen  1 , Yu-Fan Cheng  2 , Jing-Houng Wang  1 , Chih-Che Lin  3 , Chih-Chi Wang  3
Affiliations
Affiliations

    1
    Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    2
    Liver Transplantation Center, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    3
    Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

    PMID: 33439893 DOI: 10.1371/journal.pone.0244939

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Abstract

Background/aims: A recent study from the United States reported that nearly 12% of hepatocellular carcinomas (HCCs) occurred in patients without cirrhosis. Non-alcoholic fatty liver disease (NAFLD) was the most common liver disease in these patients. We aim to evaluate the characteristics, etiologies, and outcomes of cases of non-cirrhotic HCC in East Asia, where there is a higher prevalence of hepatitis B virus (HBV)-associated non-cirrhotic HCC.

Methods: This retrospective study consecutively enrolled de novo HCC patients managed at our institution from 2011 to 2017. The presence of cirrhosis was assessed by histology; if histology was not available, it was assessed by image study.

Results: 2055 patients with HCC were enrolled in this study. Among them, 529 (25.7%) were non-cirrhotic. The non-cirrhotic patients were younger (60.9 vs. 62.5 years, p = 0.006), included a greater proportion of males (78.1% vs. 71.3%, p = 0.002), and had a lower body mass index (24.3 vs. 25.3 kg/m2, p<0.001) than the cirrhotic patients. Among the non-cirrhotic patients, HBV was the most common liver disease (49.0%). The patients with non-cirrhotic HCC had larger tumors (5.9 vs. 4.7 cm, p<0.001), underwent liver resection at a higher rate (66.0% vs. 17.4%, p<0.001), and had better overall survival than the cirrhotic HCC patients (median 5.67 vs. 2.83 years, p<0.001).

Conclusions: Nearly 26% of the HCCs occurred in patients without cirrhosis. HBV was the most common liver disease in these patients, and the survival was better in the non-cirrhotic patients than the cirrhotic patients.

StephenW

无肝硬化患者的肝细胞癌的特征和病因：当East遇见West
颜一豪1，郑玉范2，王静红1，林志哲3，王智志3
隶属关系
隶属关系

    1个
    台湾高雄市长庚纪念医院和长庚大学医学院内科肝消化科。
    2
    台湾长庚大学医学院高雄长庚纪念医院诊断放射科肝移植中心，台湾。
    3
    台湾高雄市高雄市长庚纪念医院肝移植中心和外科。

    PMID：33439893 DOI：10.1371 / journal.pone.0244939

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抽象

背景/目的：美国的一项最新研究报告说，近12％的肝细胞癌（HCC）发生在无肝硬化的患者中。在这些患者中，非酒精性脂肪性肝病（NAFLD）是最常见的肝病。我们旨在评估东亚非肝硬化肝癌病例的特征，病因和结局，在这些地区，乙肝病毒（HBV）相关的非肝硬化肝癌的患病率更高。

方法：这项回顾性研究从2011年至2017年连续招募了在我们机构接受治疗的从头开始的HCC患者。如果无法获得组织学，则通过图像研究对其进行评估。

结果：2055例HCC患者参加了这项研究。其中有529例（25.7％）为非肝硬化患者。非肝硬化患者较年轻（60.9 vs. 62.5岁，p = 0.006），男性比例更高（78.1％vs. 71.3％，p = 0.002），体重指数较低（24.3 vs 25.3）。 kg / m2，p <0.001）。在非肝硬化患者中，HBV是最常见的肝病（49.0％）。非肝硬化性肝癌患者的肿瘤更大（5.9 vs. 4.7 cm，p <0.001），进行了肝切除术的比率更高（66.0％vs. 17.4％，p <0.001），并且总生存率高于肝硬化HCC患者（中位年龄为5.67年vs. 2.83年，p <0.001）。

结论：几乎26％的HCC发生在无肝硬化的患者中。乙肝病毒是这些患者中最常见的肝病，非肝硬化患者的生存率要好于肝硬化患者。

StephenW

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