Hepatitis B vs. hepatitis C infection on viral hepatitis-associated hepatocellular carcinoma

被引:43
作者
Hiotis, Spiros P. [1 ,5 ]
Rahbari, Nuh N. [2 ]
Villanueva, Gerald A. [3 ,4 ]
Klegar, Eunjie
Luan, Wei [1 ]
Wang, Qin [1 ]
Yee, Herman T. [4 ]
机构
[1] Mt Sinai Sch Med, Dept Surg, New York, NY 10029 USA
[2] Heidelberg Univ, Dept Surg, D-6900 Heidelberg, Germany
[3] NYU, Dept Gastroenterol, Bellevue Hosp, New York, NY USA
[4] NYU, Dept Pathol, Bellevue Hosp, New York, NY 10016 USA
[5] Mt Sinai Sch Med, Div Surg Oncol, New York, NY 10029 USA
关键词
Hepatocellular carcinoma; Hepatitis B; Hepatitis C; Viral hepatitis; LIVER-TRANSPLANTATION; SURGICAL OUTCOMES; VIRUS-INFECTION; CIRRHOSIS; EPIDEMIOLOGY; MANAGEMENT; RESECTION; PROGNOSIS; SURVIVAL; BURDEN;
D O I
10.1186/1471-230X-12-64
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Background: To determine clinical-pathologic variables in patients with a new diagnosis of hepatocellular carcinoma (HCC) and underlying hepatitis B vs. C infection. Methods: Patients presenting to a single urban hospital with a new diagnosis of HCC were entered into a clinical database. Variables including number and size of tumors, presence of metastases, serum alpha-Fetoprotein, hepatitis serologies, severity of hepatic dysfunction, and presence of cirrhosis were evaluated in 127 patients. Results: Patients with hepatitis B (HBV) were more likely to develop HCC at a younger age than patients with hepatitis C (HCV) (HBV-26% under age 40, HCV-0% under age 40; p< 0.001), with greater serum alpha-Fetoprotein production (median level: HBV-1000 ng/ml vs. HCV-37 ng/ml; p = 0.002), with larger tumors (HBV-78% > 5 cm, HCV-28 % > 5 cm; p< 0.001), in the absence of cirrhosis (HBV-40%, HCV-0%; p< 0.001), and a decreased eligibility for curative treatment (HBV-14%, HCV-34%; p < 0.05). Conversely, patients with HCV were more likely to develop HCC in association with multiple co-morbidities, cirrhosis, and older age. Conclusions: Significant clinical-pathologic differences exist among HCC patients with underlying HBV vs. HCV. These differences impact eligibility for potentially-curative therapy and prognosis.
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页数:7
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