目的:脂肪肝肝细胞癌(SH-HCC)是一个新提出的概念,这显示了HCC病变中脂肪性肝炎的组织学特征,在非癌性病变中,它与代谢综合征(MS)和脂肪变性/脂肪性肝炎密切相关。最近,据报道,大量与MS相关的HCC是由预先存在的炎性肝细胞腺瘤(HCA)形成的.为了阐明SH-HCC的特征,我们进行了严格诊断的SH-HCC和非SH-HCC(标准HCC)的临床病理调查。
方法:这是一项多中心回顾性研究。进行临床病理调查,以比较62例SH-HCC特征与31例年龄和性别匹配的标准HCC病例。包括使用标记进行HCA分类和HCC诊断的免疫组织化学研究。
结果:与标准HCC相比,SH-HCC的特征包括MS的并发症发生率更高,更常见的非酒精性脂肪性肝病是一种潜在的肝病,和肝癌的发展在非肝硬化肝。孤立性肿瘤的发生率在两组之间没有差异,但是SH-HCC的主要肿瘤的中位直径更大(45mm/20mm,P=0.01)。HCC大多是中等分化的,两组的模式主要是小梁。血清淀粉样蛋白A和C反应蛋白阳性,炎性HCA的分类标记,在SH-HCC病例的癌性病变中显著更高(50%/13%,P<0.01和42%/16%,分别为;P=0.01)。
结论:我们证实SH-HCC与MS和NAFLD密切相关,并发现炎症HCA的分类标志物在SH-HCC中明显更高。需要进一步的研究来阐明SH-CCC和HCA之间的关系,以了解这些疾病的致癌途径。
OBJECTIVE: Steatohepatitic hepatocellular carcinoma (SH-HCC) is a newly proposed concept, which shows histological features of steatohepatitis in HCC lesions, and it is strongly associated with metabolic syndrome (MS) and steatosis/steatohepatitis in non-cancerous lesions. Recently, a substantial number of HCC associated with MS were reported to have developed from pre-existing inflammatory hepatocellular adenoma (HCA). To elucidate the characteristic features of SH-HCC, we clinicopathologically investigated strictly diagnosed SH-HCC and non-SH-HCC (standard HCC).
METHODS: This was a retrospective multicenter study. A clinicopathological investigation was undertaken to compare 62 cases with SH-HCC features to 31 age- and sex-matched standard HCC cases, including an immunohistochemical study using markers for classification of HCA and diagnosis of HCC.
RESULTS: The characteristic features of SH-HCC compared with standard HCC include a higher rate of complications of MS, more frequent non-alcoholic fatty liver disease as an underlying liver disease, and HCC development in non-cirrhotic liver. The rate of solitary tumors showed no difference between the two groups, but the median diameter of the main tumor was greater in SH-HCCs (45 mm/20 mm, P = 0.01). The HCCs were mostly moderately differentiated, and the patterns were mainly trabecular in both groups. Positive findings for serum amyloid A and C-reactive proteins, classification markers of inflammatory HCA, were significantly higher in cancerous lesions of SH-HCC cases (50%/13%, P < 0.01 and 42%/16%, respectively; P = 0.01).
CONCLUSIONS: We confirmed that SH-HCC was strongly associated with MS and NAFLD, and found that classification markers of inflammatory HCA were significantly higher in SH-HCC. Further studies are needed to elucidate the relationship between SH-CCC and HCA for understanding the carcinogenic pathways in these diseases.