원인 미상 간세포암이 갖는 비알코올 지방간의 임상적 특징

• Published in: The Korean journal of gastroenterology Vol. 63; no. 5; pp. 292 - 298
• Main Authors: 임민영, Min Young Rim, 권오상, Oh Sang Kwon, 하민수, Minsu Ha, 김주승, Ju Seung Kim, 고광일, Kwang Il Ko, 김동규, Dong Kyu Kim, 장필규, Pil Kyu Jang, 한정윤, Jung Yoon Han, 박평화, Pyung Hwa Park, 정영걸, Young Kul Jung, 최덕주, Duck Joo Choi
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30.05.2014
• Subjects: Cryptogenic; Hepatocellular carcinoma; Metabolic syndrome; Nonalcoholic fatty liver disease; 내과학
• ISSN: 1598-9992; 2233-6869

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) may be one of the important causes of cryptogenic hepatocellular carcinoma (HCC). The aim of this study was to evaluate whether patients with cryptogenic HCC share clinical features similar to that of NAFLD. Methods: Cryptogenic HCC was defined as HCC that occurs in patients with the following conditions: HBsAg(-), anti-HCV(-), and alcohol ingestion of less than 20 g/day. All patients diagnosed with cryptogenic HCC from 2005 to 2012 (cryptogenic HCC group), and all patients diagnosed with HBV associated HCC between 2008 and 2012 (HBV-HCC group) were enrolled in the present study. Clinical features, BMI, lipid profiles, presence of diabetes mellitus, hypertension, and metabolic syndrome were compared between the two groups. Results: Cryptogenic HCC group was composed of 35 patients (19 males and 16 females) with a mean age of 70±11 years. HBV-HCC group was composed of 406 patients (318 males and 88 females) with a mean age of 56±7 years. Patients in the cryptogenic HCC group were older (p=0.001) and female dominant (p=0.042) than those in the HBV-HCC group. There were no differences in the laboratory test results including lipid profiles and Child-Turcotte-Pugh class between the two groups. Patients in the cryptogenic HCC group had higher prevalence of diabetes (37% vs. 17%, p=0.015), hypertension (49% vs. 27%, p=0.051), metabolic syndrome (37% vs. 16%, p=0.001), and higher BMI (25.3 kg/m2 vs. 24.1 kg/m2, p=0.042) than those in the HBV- HCC group. The tumor stage was more advanced (stage III and IV) at diagnosis in the cryptogenic HCC group than in the HBV-HCC group (60% vs. 37%, p=0.007). Conclusions: Cryptogenic HCC has clinical features similar to that of NAFLD and is diagnosed at a more advanced tumor stage.