无慢性病毒感染或酒精滥用患者发生的肝细胞癌（HCC）的临床病理特征：对接受肝切除术患者的回顾性研究

Clinicopathological features of hepatocellular carcinomas (HCCs) arising in patients without chronic viral infection or alcohol abuse: a retrospective study of patients undergoing hepatic resection.

作者信息

Yokoi Yoshihiro, Suzuki Shohachi, Baba Satoshi, Inaba Keisuke, Konno Hiroyuki, Nakamura Satoshi

机构信息

Department of Surgery, Social Insurance Hamamatsu Hospital, 1-8-1 Nakajima, Hamamatsu, 430-0856, Japan.

出版信息

J Gastroenterol. 2005 Mar;40(3):274-82. doi: 10.1007/s00535-004-1536-1.

DOI:10.1007/s00535-004-1536-1

PMID:15830287

Abstract

BACKGROUND

This study was carried out to clarify the etiology and clinicopathological features of hepatocellular carcinomas (HCCs) arising in patients without chronic viral infection or alcohol abuse.

METHODS

HCC patients who underwent resection were divided into three groups: a non-B non-C (NBNC) group (n = 13), who were seronegative for hepatitis B surface antigen (HBs Ag) and anti-hepatitis C antibody (HCV Ab), excluding a history of alcohol abuse; a B group (n = 25), who were seropositive for HBs Ag only; and a C group (n = 116), who were seropositive for HCV Ab only. We analyzed the features of tumor- and host-related factors and the outcome of the NBNC group.

RESULTS

Hepatic inflammation and fibrosis were less severe in the NBNC group than in the other groups. There were no significant differences in tumor-related factors, except for higher serum levels of alpha-fetoprotein in the NBNC group. Recurrence rates and disease-free survivals were comparable among the three groups. The NBNC group comprised a greater population with one or two recurrent hepatic lesions (P < 0.05), and indocyanine green retention rates and fibrosis scores were preserved after the initial hepatectomy. The NBNC group had higher resection rates for intrahepatic recurrences (75.0%) than the other groups (21.1% and 22.2% in groups B and C, respectively; P < 0.05 and P < 0.05). The survival rate after the initial hepatectomy or detection of the recurrent lesions was significantly better in the NBNC group (both 100% at 5 years) than those in groups B and C (P < 0.05).

CONCLUSIONS

NBNC patients maintained good liver function following the initial hepatectomy, and tended to have one or two recurrent lesions. These biological advantages provided NBNC patients more opportunities for repeat resection of intrahepatic recurrences, which may lead to a favorable outcome.

摘要

背景

本研究旨在阐明无慢性病毒感染或酗酒患者发生肝细胞癌（HCC）的病因及临床病理特征。

方法

将接受手术切除的HCC患者分为三组：非B非C（NBNC）组（n = 13），乙肝表面抗原（HBs Ag）和抗丙型肝炎抗体（HCV Ab）血清学阴性，且无酗酒史；B组（n = 25），仅HBs Ag血清学阳性；C组（n = 116），仅HCV Ab血清学阳性。我们分析了肿瘤和宿主相关因素的特征以及NBNC组的预后。

结果

NBNC组的肝脏炎症和纤维化程度低于其他组。除NBNC组甲胎蛋白血清水平较高外，肿瘤相关因素无显著差异。三组的复发率和无病生存率相当。NBNC组中一个或两个复发性肝病灶的患者比例更高（P < 0.05）；初次肝切除术后，吲哚菁绿潴留率和纤维化评分得以保留。NBNC组肝内复发的切除率（75.0%）高于其他组（B组和C组分别为21.1%和22.2%；P < 0.05和P < 0.05）。初次肝切除或复发病灶检测后的生存率，NBNC组（均为5年时100%）显著高于B组和C组（P < 0.05）。