| 特集名 | 非B非C型肝癌―最新の知見 | |
|---|---|---|
| 題名 | わが国における非B非C型肝硬変の実態 | |
| 発刊年月 | 2012年 05月 | |
| 著者 | 青木 智子 | 兵庫医科大学内科肝胆膵科／兵庫医科大学超音波センター |
| 著者 | 飯島 尋子 | 兵庫医科大学内科肝胆膵科／兵庫医科大学超音波センター |
| 著者 | 西口 修平 | 兵庫医科大学内科肝胆膵科 |
| 【 要旨 】 | 非B非C型肝硬変の成因別頻度を明らかにした第15回日本肝臓学会大会（2011）の主題ポスターでは，新しく脂肪性肝硬変(脂肪肝を基盤として，飲酒量が20〜70 g／dayのもの)を成因に加えた点が注目される．過去の全国集計と比較すると，非B非C型肝硬変は1998年21.8％，2008年24％，2011年26％と漸増傾向にあった．2011年に集計した非B非C型肝硬変6,999症例の内訳をみると，アルコール性55.1％，NASH14.5％，PBC8％，AIH6.8％，脂肪性2.5％，原因不明10.5％であった．2008年の集計と比して，アルコール性肝硬変の割合は変わらないが，NASH肝硬変の割合は有意に増加していた(14.5％ vs 8.7％；P＜0.001)．脂肪性肝硬変は男性に多く，糖尿病や脂質異常症の合併がNASH同様に高く，肝癌合併率も高かった． また当院の検討では，非B非C型肝癌症例32例のうち9例の血清・正常肝組織から，HBV DNAが検出されており，32例中1例ではB型肝癌を示唆するintegrated HBV DNAの存在が確認された．非B非C型のなかには一定の確率でoccult HBVが含まれており，今後の検討課題と思われた． |
|
| Theme | Non-B, Non-C Hepatocellular Carcinoma : The Latest Findings | |
|---|---|---|
| Title | The True State of Non-B Non-C Liver Cirrhosis in Japan | |
| Author | Tomoko Aoki | Department of Internal Medicine, Division of Hepatobiliary and Pancreatic Disease, Department of Ultrasound Center, Hyogo College of Medicine |
| Author | Hiroko Iijima | Department of Internal Medicine, Division of Hepatobiliary and Pancreatic Disease, Department of Ultrasound Center, Hyogo College of Medicine |
| Author | Shuhei Nishiguchi | Department of Internal Medicine, Division of Hepatobiliary and Pancreatic Disease, Hyogo College of Medicine |
| [ Summary ] | It was announced at the JDDW 2011 conference that the number of HBs Ag negative and HCV Ab negative liver cirrhosis (NBNC-LC) cases is gradually increasing. The rates of increase are as follows: 1998 21.8 %, 2008 24 % and 2011 26 %. In 2011, the frequency of alcohol related cases was 55.1 %, NASH related were 14.5 %, PBC related were 8 %, AIH were 6.8 %, fatty liver cases (based on steatohepatitis and alcohol consumption rates of 20-70 g/day) were 2.5 %, and the number of cases related to cryptogenic liver cirrhosis was 10.5 %. The frequency of alcohol related liver cirrhosis cases in 2011 was the same as in 2008. However, the frequency of NASH in 2011 was higher than in 2008 (14.5 % vs 8.7 %; P<0.001). Fatty liver cirrhosis has become a new criteria, which was developed at the JDDW2011 conference. It is characterized by complications due to diabetes mellitus, hyperlipemia, and hepatocellular carcinoma. It was determined that NBNC-HCCs cases were occasionally associated with occult HBV infections. We detected 9 HBV DNA related cases from serum and normal liver tissues of 32 NBNC-HCC patients by employing nested PCR. One involved integrated HBV DNA in the tumor tissue, as determined by Southern blot analysis. |
|