PDF(Pubmed)
Abstract：
Background: There remains a scarcity of published data on the clinical significance of paraneoplastic cutaneous manifestations in hepatocellular carcinoma (HCC). Method: A systematic search of MEDLINE was performed in December 2022. Inclusion criteria comprised studies reporting on patients with HCC, who had paraneoplastic cutaneous manifestations. Outcomes of interests comprise survival and response to cancer-directed and/or skin directed therapy. Results: A total of 48 studies comprising 60 HCC patients were included in the analysis. The most frequent reported skin abnormalities were dermatomyositis, pityriasis rotunda, and porphyria. Most patients presented with dermatomyositis had underlying viral hepatitis, while all reported porphyria and acanthosis cases were associated with metabolic causes of HCC, such as steatosis. Paraneoplastic skin changes were more common in patients with metastatic disease. Pityriasis Rotunda was associated with the lowest risk of death, (OR: 0.05, 95% CI: 0.003 to 0.89; p = 0.04), while dermatomyositis had a statistically significant higher risk of death (OR: 3.37, 95% CI: 1.01-12.1; p = 0.03). Most patients showed an improvement in their cutaneous abnormalities, following cancer-directed therapy. Conclusion: Paraneoplastic cutaneous manifestations are reported more frequently in patients with a higher burden of disease, especially presence of metastases. Certain cutaneous manifestations have prognostic implication.
摘要：
背景：关于肝细胞癌（HCC）副肿瘤皮肤表现的临床意义的公开数据仍然很少。方法：2022年12月对MEDLINE进行系统检索。纳入标准包括报告肝癌患者的研究，有副肿瘤皮肤表现的人。感兴趣的结果包括存活和对癌症定向和/或皮肤定向治疗的响应。结果：共有48项研究包括60例HCC患者。最常见的皮肤异常是皮肌炎，圆形糠疹,和卟啉症。大多数皮肌炎患者有潜在的病毒性肝炎，虽然所有报告的卟啉症和棘皮病病例都与HCC的代谢原因有关，比如脂肪变性。副肿瘤性皮肤变化在转移性疾病患者中更为常见。轮曲糠疹与最低的死亡风险相关，（OR：0.05，95%CI：0.003至0.89；p=0.04），而皮肌炎的死亡风险具有统计学意义（OR：3.37，95％CI：1.01-12.1；p=0.03）。大多数患者的皮肤异常有所改善，癌症定向治疗后。结论：在疾病负担较高的患者中，副肿瘤皮肤表现更频繁。尤其是存在转移。某些皮肤表现具有预后意义。
