Risk factors for hepatocellular carcinoma in cirrhosis: A comprehensive analysis from a decade-long study.

Autor:	Zhou DQ; Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China., Liu JY; Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China., Zhao F; Hepatology Center, Baoding People's Hospital, Baoding 071000, Hebei Province, China., Zhang J; Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China., Liu LL; Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China., Jia JR; Hepatology Center, Baoding People's Hospital, Baoding 071000, Hebei Province, China., Cao ZH; Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China. caozhenhuanyu@mail.ccmu.edu.cn.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal oncology [World J Gastrointest Oncol] 2024 Dec 15; Vol. 16 (12), pp. 4625-4635.
DOI:	10.4251/wjgo.v16.i12.4625
Abstrakt:	Background: Cirrhosis is a significant risk factor for the development of hepatocellular carcinoma (HCC). Variability in HCC risk among patients with cirrhosis is notable, particularly when considering the diverse etiologies of cirrhosis. Aim: To identify specific risk factors contributing to HCC development in patients with cirrhosis. Methods: This retrospective study analyzed data from cirrhotic patients at Beijing Youan Hospital from January 1, 2012 to September 30, 2022 with at least 6 mo of follow-up. Patient demographics, medical histories, etiologies, and clinical characteristics were examined. Cox regression analysis was used to analyze correlations of the above parameters with hepatocarcinogenesis, while competing risk regression was used to estimate their adjusted hazard ratios accounting for death. The cumulative incidence was plotted over time. Results: Overall, 5417 patients with cirrhosis (median age: 54 years; 65.8% males) were analyzed. Hepatitis B virus (HBV) was the most common etiology (23.3%), with 25% ( n = 1352) developing HCC over a 2.9-year follow-up period. Patients with multiple etiologies had the HCC highest incidence (30.3%), followed by those with HBV-related cirrhosis (29.5%). Significant risk factors included male sex, advanced age, hepatitis C virus (HCV) infection, elevated blood ammonia, and low platelet count. Men had a higher 5-year HCC risk than women (37.0% vs 31.5%). HBV, HCV, and HBV/HCV co-infected patients had 5-year risks of HCC of 45.8%, 42.9%, and 48.1%, respectively, compared to 29.5% in nonviral hepatitis cases, highlighting the significant HCC risk from viral hepatitis, especially HBV, and underscores the importance of monitoring these high-risk groups. Conclusion: In conclusion, HBV-related cirrhosis strongly correlates with HCC, with male sex, older age, viral hepatitis, elevated blood ammonia, and lower albumin and platelet levels increasing the risk of HCC. Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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