Abstract：
Beyond oral contraceptives (OCs), metabolic factors have been suggested to increase the risk of hepatocellular adenoma (HCA). The impact of risks remains poorly defined, particularly among men and those with adenomatosis. Thus, we aimed to examine HCA clinical and outcome characteristics through a large multicenter cohort.
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 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.
摘要：
除了口服避孕药（OCs），代谢因素被认为会增加肝细胞腺瘤（HCA）的风险。风险的影响仍然定义不清，尤其是男性和腺瘤病患者。因此，我们旨在通过大型多中心队列研究HCA临床和结局特征.
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。
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。
