与MASLD相关的HCC:多中心研究比较患有肝硬化和没有肝硬化的患者
Carole Vitellius1,2, Elvire Desjonqueres3, Marie Lequoy4
1Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, Angers, France.
JHEP reports : innovation in hepatology
|October 16, 2024
概括
与代谢功能障碍相关的脂肪性肝病 (MASLD) 中的肝细胞癌 (HCC) 发生在35%的非肝硬化患者中. 这些患者,尽管预后因素较差,但接受了更积极的治疗,并且比肝硬化患者的生存率更好.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 代谢疾病 代谢疾病
背景情况:
- 与代谢功能障碍相关的脂肪性肝病 (MASLD) 是肝细胞癌 (HCC) 的日益严重的原因.
- 在非肝硬化 MASLD 肝脏中的 HCC 了解甚微.
- 预计到2030年,与MASLD相关的HCC发病率将大幅增加.
研究的目的:
- 为了比较MASLD相关的HCC的特征,管理,存活率和趋势,在有肝硬化和没有肝硬化的患者中进行比较.
- 调查与MASLD相关的HCC的预后因素.
- 为了评估与MASLD相关的HCC在非肝硬化患者的治疗策略.
主要方法:
- 对来自法国四所大学医院的354例MASLD相关HCC病例 (2007-2018) 的回顾性分析.
- 从肝癌委员会数据库和法国出生死亡登记处提取的数据.
- 患者特征,瘤负担,肝功能,治疗和肝硬化和非肝硬化组之间的存活率的比较.
主要成果:
- 35%的MASLD相关的HCC病例发生在非肝硬化肝脏中.
- 非肝硬化患者年龄较大,瘤较大,但肝功能更好.
- 非肝硬化患者接受手术的频率更高 (41%对11%),整体存活率更好 (p=0.043).
- 肝硬化不是生存的独立预测因素;年龄,肝功能,瘤负担和BCLC分类是关键因素.
结论:
- 在非肝硬化患者中,MASLD相关的HCC呈现出不良的预后因素,但肝功能更好.
- 包括手术在内的积极管理是可行的,并且导致非肝硬化患者的生存率更高.
- 了解非肝性MASLD-HCC病理生理学对于早期查和管理至关重要.
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