3013例肝细胞癌的研究：近十年前及十年间的病因及治疗

StephenW

3013例肝细胞癌的研究：近十年前及十年间的病因及治疗
Miao-Shan Lim 1 , George BB Goh 1 , Jason PE Chang 1 , Jee-Keem Low 2 , Vishalkumar G Shelat 2 , Terence CW Huey 2 , Yock-Young Dan 3 , Alfred Kow 4 , Iyer Shridhar 4 , Poh-Seng Tan 3 , Sameer P Junnarkar 2 , Chee-Kiat Tan 1
隶属关系
隶属关系

    1
    新加坡中央医院肝脏病学和胃肠病学系。
    2
    新加坡陈笃生医院普通外科（肝-胰-胆外科服务）。
    3
    新加坡国立大学医疗系统大学医学集群胃肠病学和肝病学部。
    4
    新加坡国立大学卫生系统大学外科集群肝胆胰外科科。

    PMID：34584969 PMCID：PMC8454472 DOI：10.1002/jgh3.12624

抽象的

背景和目的：肝细胞癌（HCC）是一个重要的全球性问题。随着 HCC 诊断和治疗的进步，我们的假设是多年来 HCC 的临床特征和治疗存在显着差异。

方法：1980 年至 2018 年期间来自新加坡三大三级医院的 HCC 患者被纳入研究电子数据采集数据库。比较了 2008 年之前（队列 A）和当前十年（即从 2008 年起）（队列 B）诊断出的 HCC 的临床特征和治疗。

结果：3013例患者。队列 B 中 HCC 诊断的平均年龄显着更高（68.6 岁 vs 61.2 岁，P < 0.001）。最常见的病因仍然是慢性乙型肝炎感染，但 B 队列中由乙型肝炎引起的比例显着较低（46.6% 对 57.2%，P < 0.0001）。队列 B 中隐源性/非酒精性脂肪性肝炎的患病率显着高于队列 A（27.1% 对 18.6%，P < 0.0001）。在 B 组中，更多患者接受了治愈性治疗（43.7% 对 27.1%，P < 0.0001。

结论：在新加坡最大的 HCC 患者集合中，患者在年龄较大时被诊断出患有 HCC，并且隐源性/非酒精性脂肪性肝炎在当前十年中作为 HCC 的病因变得越来越重要。在当前的十年中，更多的患者也接受了治愈性治疗。

关键词：慢性乙型肝炎；流行病学；肝细胞癌;非酒精性脂肪性肝炎。

© 2021 作者。 JGH Open 由Journal of Gastroenterology and Hepatology Foundation 和John Wiley & Sons Australia, Ltd. 出版。

StephenW

A study of 3013 cases of hepatocellular carcinoma: Etiology and therapy before and during the current decade
Miao-Shan Lim  1 , George B-B Goh  1 , Jason P-E Chang  1 , Jee-Keem Low  2 , Vishalkumar G Shelat  2 , Terence C-W Huey  2 , Yock-Young Dan  3 , Alfred Kow  4 , Iyer Shridhar  4 , Poh-Seng Tan  3 , Sameer P Junnarkar  2 , Chee-Kiat Tan  1
Affiliations
Affiliations

    1
    Department of Hepatology and Gastroenterology Singapore General Hospital Singapore.
    2
    Department of General Surgery (Hepato-Pancreato-Biliary Surgery Service) Tan Tock Seng Hospital Singapore.
    3
    Division of Gastroenterology and Hepatology, University Medicine Cluster National University Health System Singapore.
    4
    Division of Hepatobiliary and Pancreatic Surgery, University Surgical Cluster National University Health System Singapore.

    PMID: 34584969 PMCID: PMC8454472 DOI: 10.1002/jgh3.12624

Abstract

Background and aim: Hepatocellular carcinoma (HCC) is a significant global problem. With advances in HCC diagnosis and therapy, our hypothesis is that there are significant differences in the clinical characteristics and treatment of HCC over the years.

Methods: Patients with HCC between 1980 and 2018 from three major tertiary hospitals in Singapore were enrolled into a Research Electronic Data Capture database. Clinical characteristics and treatment of HCC were compared between those diagnosed before 2008 (cohort A) and during the current decade (ie from 2008 onwards) (cohort B).

Results: There were 3013 patients. Mean age of HCC diagnosis was significantly older in cohort B (68.6 vs 61.2 years, P < 0.001). The most common etiology remained as chronic hepatitis B infection but the proportion due to hepatitis B was significantly lower in cohort B (46.6% vs 57.2%, P < 0.0001). The prevalence of cryptogenic/non-alcoholic steatohepatitis was significantly higher in cohort B than cohort A (27.1% vs 18.6%, P < 0.0001). More patients received curative therapy in cohort B (43.7% vs 27.1%, P < 0.0001.

Conclusion: In this largest collection of HCC patients in Singapore, patients are diagnosed with HCC at an older age and cryptogenic/non-alcoholic steatohepatitis is becoming more important as an etiology of HCC in the current decade. More patients also received curative therapy in the current decade.

Keywords: chronic hepatitis B; epidemiology; hepatocellular carcinoma; non‐alcoholic steatohepatitis.

© 2021 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

StephenW

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jgh3.12624

疯一点好

请教斯蒂芬:    在当前的十年中，更多的患者也接受了治愈性治疗。


这句话什么意思？

StephenW

回复 疯一点好 的帖子

"Over the years, there have been advances in the diagnosis
and treatment of HCC.6 The dynamic imaging modalities of
computerized tomography (CT) and magnetic resonance imaging
(MRI)7 allow definitive diagnosis of early HCC detected during
surveillance with ultrasound,8 hence improving the chances of
curative treatment"
多年来，在诊断方面取得了进展6 HCC 的动态成像方式
计算机断层扫描 (CT) 和磁共振成像(MRI)7 可明确诊断在治疗期间检测到的早期 HCC
用超声波进行监测，8 从而提高了治疗 .

Treatment modalities for HCC were further divided into
curative, palliative, and best supportive care. Curative treatment
modalities include surgical resection, percutaneous ethanol injec-
tion therapy (PEIT), radiofrequency ablation (RFA), and liver
transplantation. Palliative modalities include transhepatic arterial
chemoembolization (TACE), selective internal radiation (SIRT),
sorafenib, or other systemic chemotherapy.
HCC的治疗方式进一步分为
治疗性、姑息性和最佳支持性护理。 治疗方法包括手术切除、经皮乙醇注射
治疗 (PEIT)、射频消融 (RFA) 和肝脏移植。 姑息疗法包括经肝动脉化疗栓塞 (TACE)、选择性内照射 (SIRT)、索拉非尼或其他全身化疗。

意思是 : 在当前[从 2008 年开始 ]的十年中，更多的[HCC患者][与 1980 年至 2008 年的 HCC 患者相比 ]接受了治愈性治疗. [43.7% vs 27.1%, P < 0.0001.]

因为 :
1. 更早地发现 HCC ;
2. 更多治疗方法 .

疯一点好

谢谢斯蒂芬，这么耐心答复，由衷感谢！

挚友888888

回复 StephenW 的帖子

谢谢STEPHENW，一直发帖子。可惜你在北京，否则一定到你单位拜访您，您确实是个很好的医生。不知道什么原因一直进不了论坛，今天总算进了论坛。希望论坛一直能开放。

StephenW

回复 挚友888888 的帖子

谢谢, 我在悉尼 ,澳大利亞.

挚友888888

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