HCA diagnosis was made based on a combination of clinical, radiologic, and histologic criteria. Patient and clinical data including follow-up imaging, complications, and interventions were collected between 2004 and 2018 from 3 large academic centers.
Among 187 patients (163 female and 24 male) with HCA, 75 had solitary HCA, 58 had multiple HCAs, and 54 had adenomatosis. Over a median follow-up of 3.3 years (quartile 1: 1.2, quartile 3: 8.8), 34 patients (18%) had radiologic interventions, 41 (21%) had surgical resections, 10 (5%) developed tumoral hemorrhage, and 1 had malignant transformation. OC and corticosteroid use were present in 70% and 16%, respectively. Obesity (51%), type 2 diabetes (24%), hypertension (42%), and hypertriglyceridemia (21%) were also common. Metabolic comorbidities were more common in patients with large HCAs and adenomatosis. Compared with women, men had less hepatic steatosis (4% vs 27%), smaller HCAs (2.3 cm vs 4.4 cm), and more corticosteroid use (38% vs 11%) ( P < 0.05 for all). With OC cessation, 69% had a decrease in size of HCA, but 25% eventually required advanced interventions.
In this large HCA cohort, obesity and metabolic comorbidities were important risk factors associated with large HCAs and adenomatosis. Long-term adverse outcomes were infrequent, 5% had tumor hemorrhage, and 1 patient exhibited malignant transformation.
HCA诊断是基于临床,放射学,和组织学标准。患者和临床数据,包括随访影像,并发症,2004年至2018年期间,从3个大型学术中心收集了干预措施.
在187名HCA患者(163名女性和24名男性)中,75人患有单独的HCA,58有多个HCA,54人患有腺瘤病。平均随访3.3年(四分位数1:1.2,四分位数3:8.8),34名患者(18%)接受了放射学干预,41例(21%)手术切除,10(5%)发生肿瘤出血,1有恶变。OC和皮质类固醇的使用占70%和16%,分别。肥胖(51%),2型糖尿病(24%),高血压(42%),高甘油三酯血症(21%)也很常见。代谢合并症在大型HCA和腺瘤病患者中更为常见。与女性相比,男性肝脏脂肪变性较少(4%vs27%),较小的HCA(2.3厘米vs4.4厘米),和更多的皮质类固醇使用(38%比11%)(P<0.05)。随着OC的停止,69%的人的HCA大小有所减少,但25%的人最终需要先进的干预措施。
在这个庞大的HCA队列中,肥胖和代谢合并症是与大型HCA和腺瘤病相关的重要危险因素.长期不良结局很少见,5%有肿瘤出血,1例患者出现恶变。