잠시만 기다려 주세요. 로딩중입니다.

Potential etiology, prevalence of cirrhosis, and mode of detection among patients with non-B non-C hepatocellular carcinoma in Korea

Korean Journal of Internal Medicine 2020년 35권 1호 p.65 ~ 78
김지혜 ( Kim Ji-Hye ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine

강원석 ( Kang Won-Seok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
신동현 ( Sinn Dong-Hyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
곽금연 ( Gwak Geum-Youn ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
백용한 ( Paik Yong-Han ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
최문석 ( Choi Moon-Seok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
이준혁 ( Lee Joon-Hyeok ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
고광철 ( Koh Kwang-Cheol ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
백승운 ( Paik Seung-Woon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine

Abstract


Background/Aims: We systematically evaluated the clinical characteristics, prevalence of cirrhosis, and mode of detection in virus-unrelated (non-B non-C, NBNC) hepatocellular carcinoma (HCC) patients in Korea.

Methods: A total of 447 consecutive treatment-naive NBNC-HCC adult patients who were registered at the Samsung Medical Center HCC registry in Korea from 2010 to 2013 were analyzed. NBNC was defined as negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody. Presence of cirrhosis was determined based on histological, radiological, endoscopic, and serologic results. Mode of detection was classified as either under surveillance, incidental, or symptomatic.

Results: Heavy alcohol use was the most common potential etiology in NBNCHCC (NBNC-A, alcohol) (59.7%). Ten patients had other identifiable causes (NBNC-O, other identifiable cause) such as autoimmune hepatitis. The rest (38.0%) had no-identifiable cause (NBNC-NA-NO, non-alcohol, no-other identifiable cause). In NBNC-NA-NO group, 83.5% (96/115) of patients with available hepatitis B core immunoglobulin G antibody (HBcIgG) showed HBcIgG positivity, and 80.6% (137/170) had metabolic risk factors (diabetes, obesity, hypertension, and/ or dyslipidemia). Cirrhosis was present in 90.0%, 70.4%, and 60.0% of NBNC-O, NBNC-A, and NBNC-NA-NO patients, respectively. The proportion of patients diagnosed under surveillance was 25.5% across all patients, with specific proportions being 80.0%, 27.7%, and 18.8% for NBNC-O, NBNC-A, and NBNC-NA-NO, respectively.

Conclusions: Among NBNC-HCC patients, heavy alcohol use or any other identifiable cause was not found in 38.0%. These NBNC-NA-NO HCC patients showed a high prevalence of HBcIgG positivity and metabolic risk factors, suggesting that prior hepatitis B virus infection and metabolic risk factors may be major contributing factors in the hepatocarcinogenesis in NBNC-NA-NO patients.

키워드

Non-B non-C; Carcinoma, hepatocellular; Etiology; Liver cirrhosis
원문 및 링크아웃 정보
  
등재저널 정보